Knee surgery 'unnecessary for mild osteoarthritis'

People with mild forms of osteoarthritis may be better served by avoiding unnecessary arthroscopic knee surgery, according to new Canadian research.

Carried out by McMaster University in Ontario, the meta-analysis review looked at data from seven published randomised control trials between 1946 and 2014 on the success of arthroscopic partial meniscectomy in patients with mild or no osteoarthritis, compared with non-surgical treatment approaches. In total, 811 knees among 805 patients with a mean age of 56 years were assessed.

According to results published in the Canadian Medical Association Journal, in four of the trials there was no short-term pain relief in the first six months after surgery for patients with some osteoarthritis.

Moreover, there was shown to be no discernible improvement in long-term function up to two years later in five of the studies.

Dr Moin Khan, principal investigator for the study and research fellow in orthopaedic surgery at the university's Michael G DeGroote School of Medicine, said: "This study shows that surgery should not be the initial option for middle-aged or older patients, as there is limited evidence supporting partial meniscectomy surgery for meniscus tears. Other treatments should be used first."

Each year, more than four million keyhole surgeries are performed worldwide for degenerative meniscus tears. The minimally invasive procedure involves making small incisions to remove the torn fragments from the damaged meniscus.

Despite its popularity, previous studies have also suggested that arthroscopic knee surgery may not be effective for long-term symptom relief among severe knee arthritis patients either, suggesting its status as a first-choice option should be challenged.

A spokeswoman for Arthritis Research UK said: "There's a place for surgery in severe, advanced knee osteoarthritis but in milder cases, losing weight and doing regular exercises to strengthen the quadriceps muscle that supports the knee joint is far more effective.

"Arthroscopic washouts are only recommended by the National Institute for Health and Clinical Excellence (NICE) when the knee joint locks, and it's largely been discredited as a form of pain relief."