Most patients believe that arthroscopic knee surgery is some sort of “fix” for their knee. However, increasingly, the research isn’t bearing out that this is the case. A new research study shows again that you should really be considering knee arthroscopy alternatives. Why? An alarming 1 in 4 patients that undergo a knee arthroscopic surgery will end up with a knee replacement within 3 years!
Arthroscopic knee surgery began in the 1980s and was a great advance over the open surgeries that came before. In the United States and worldwide it’s become the number one orthopedic procedure in common use with about 4 million surgeries per year. However, the research of the past decade hasn’t really shown that it’s most common uses actually help patients. For example, arthroscopic surgery to “clean up” the knee is no better than fake placebo surgery. In addition, a recent spate of studies showed that meniscus surgeries for almost any reason were either no better than physical therapy or no surgery.
The new study looked at patients who were over 50 who had arthroscopic surgery to “repair” meniscus tears. First, it’s important to know that in patients this age there is no such thing as a meniscal repair, but almost always what happens is the removal of knee meniscus tissue. The surgical team used a two surgeon team to independently evaluate who really needed a knee replacement after a failed knee arthroscopy to try to reduce the rate of knee replacement surgery. Regrettably, they couldn’t really reduce the number of knee replacements needed in a significant way and the overall rate of conversion to a knee replacement was 26% over 3 years. Alarmingly, that rate rose to 36% if the patient was 65 years or older!
The upshot? You should realize that this study likely underestimates the number of knee arthroscopy patients that end up rapidly needing a knee replacement in that these surgeons were consciously trying to reduce that rate. The study highlights just how little knee arthroscopy for degenerative mensicus tears does to help patients. In addition, we’re likely to see more studies like this one as Obamacare comes into full swing, as doctors will get financial incentives to ration care. However, if the bean counters are really in control, I expect that many fewer arthroscopic knee surgeries will be happening over the next decade based on studies like this one.