Thursday, September 11, 2008

Knee surgery? Maybe not

About 1 million Americans a year have arthroscopic knee surgery to treat arthritis, but they might do just as well with medication and physical therapy, today's New England Journal of Medicine reports. New research questions whether many people with arthritis are having needless knee surgery.

Nearly 27 million Americans have osteoarthritis. It's a leading cause of disability. Symptoms usually begin after age 40 and progress as a breakdown of cartilage on the ends of bones causes them to rub together.

With arthroscopic surgery, surgeons smooth damaged cartilage surfaces on the bones' ends and flush out bone chips. This allows quicker healing than traditional surgery but can still trigger side effects including blood clots, infection and nerve damage. The cost: about $7,000 as an outpatient procedure.

In the study at the University of Western Ontario, 86 of 178 patients with moderate to severe arthritis of the knee got only physical and medical therapy. The rest had arthroscopic surgery, too. Two years later, both groups had improved equally.

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