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"This study provides definitive evidence that arthroscopic surgery provides no additional therapeutic value when added to physical therapy and medication for patients with moderate osteoarthritis of the knee," said study co-author Dr. Brian Feagan, Clinical Trials Director at the Robarts Research Institute and professor of Schulich School of Medicine & Dentistry at The University of Western Ontario.
Osteoarthritis affects an estimated 27 million Americans and one in every ten Canadians. Knee osteoarthritis leads to 418,000 knee replacement procedures annually and in 2006 accounted for 496,000 hospital discharges and spent $19 billion in hospital charges, according to the Centers for Disease Control and Prevention.
The study followed for two years 178 men and women at an average of 60 who lived in London, Canada and had moderate to severe osteoarthritis of the knee. All patients received physical therapy and medications such as ibuprofen or acetaminophen and 86 percent of them also received surgery consisting of lavage and arthroscopic debridement.
The researchers found all patients improved their condition with regard to joint pain, stiffness, and function. But surgery did not offer any additional benefit.
Although the study did not show benefits of arthroscopic debridement, study co-author Dr. Bob Litchfield, the Medical Director of the Fowler Kennedy Sport Medicine Clinic said "knee arthroscopy is still beneficial in many other conditions affecting the knee, such as meniscal repair and resection, and ligament reconstruction."
A press release by University of Western Ontario states a 2002 study shows similar results, but got dismissed by the medical community and arthroscopic surgery is still commonly performed on patients with osteoarthritis of the knee to remove cartilage fragments and smoothes the joint surfaces in an effort to relieve joint pain and stiffness.
"The Moseley study was published in the New England Journal of Medicine in 2002. Many orthopedic surgeons did not accept the result and there were many criticisms of the methodology used in that trial" because the study only included older men, said Dr. Feagan. The current study included both men and women to demonstrate that the previous findings are applicable to both men and women.
"I would hope that evidence-based medicine is embraced by everyone, particularly health care providers. We need to know when things are working and when they're not," said Litchfield.
Those who do not want to use too much of medications may consider using some alternative medicine.
A new study published in the August 2008 issue of journal of Phytotherapy Research, showed Pycnogenol, bark extract from the French maritime pine tree, reduced overall knee osteoarthritis (OA) symptoms by 20.9 percent and pain by 40.3 percent.
Dr. Peter Rohdewald, one of the researchers of the study, of Slovakia's Comenius University School of Medicine said "The pain is gradually decreasing during the course of three months treatment with Pycnogenol. An improvement is found after the first month and a further improvement is seen after two months."
There are other ways to help control knee osteoarthritis. The Arthritis Foundation recommends the following, cited in verbatim from a press release:
• Learn techniques to manage your arthritis. Participate in the Arthritis Foundation Self-Help Program, a self-management course that teaches people with arthritis how to manage the pain and challenges that arthritis imposes. The course has been shown to lead to a 40% reduction in pain.
• Control weight. For those already living with symptoms, losing 15 pounds can cut knee pain in half. Maintaining a healthy weight also can lower a person’s risk of osteoarthritis. In fact, one study showed that women who lost as little as 11 pounds halved their risk of developing knee osteoarthritis and its accompanying joint pain.
• Get active. Many people think that physical activity
can worsen arthritis. Nothing could be further from the truth. Physical
activity can help decrease symptoms of osteoarthritis.
In addition, physical activity is an important component of weight control and helps maintain healthy bones, muscles and joints. For joint-safe exercise programs, try the Arthritis Foundation’s Life Improvement Series land or water exercise programs. |
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