A recently published article from the University of Western Ontario in the New England Journal of Medicine, calls into question the efficacy of arthroscopy for the treatment of moderate-to-severe osteoarthritis of the knee. Researchers studied nearly 200 patients with moderate-to-severe osteoarthritis of the knee. They divided the patients into two groups. One group received medication, weekly physical therapy, and an exercise regimen. The other group of patients received the same treatment plus arthroscopic surgery of the knee. After two years, both groups of patients reported the same pain levels, physical function, and overall quality of life. The authors of the study felt their conclusions did not support the use of arthroscopic surgery for treatment of moderate-to-severe osteoarthritis.
There have been previously published studies that have indicated for the treatment of pain alone, arthroscopic surgery for moderate-to-severe arthritis is no better than nonoperative treatment. However, in milder forms of arthritis, particularly those associated with mechanical symptoms, i.e. catching and locking type symptoms from a torn meniscus or cartilage, arthroscopic surgery has proved beneficial.
If you have moderate-to-severe osteoarthritis of the knee and associate pain, but without significant mechanical symptoms, the use of arthroscopic surgery to treat that may be no better than nonoperative treatment methods. You should discuss the options with your surgeon when contemplating what to do about symptoms associated with osteoarthritis of the knee.
Hello Dr. Barrett I am a 48 year old woman who feels 80 years old. I have had orthoscopic surgey on my right knee and have never had an ounce of relief. Its been a couple of years. I went to see my Orthopedic Dr. but hesays i am to young for the knee replacement. After numerous times in his office he has been draining my knee. 2 times per month.I had the ortovisc injection and had no relief.I cant handle this pain anylonger.I cant walk for very long without stopping because of the excrusiating pain. Ican HONESTLY say i cant take it no-more.My Dr.Bobko has referred me to see Dr.Edmunston in Tacoma for another opinion.On December 1,2008 at 2:15 pm.I dont want this to be a waste of time. I really want something done. I cant do anything i use to.Its even hard to go outside and play catch with my grandson. I have to stop what im doing all the time cause the pain gets so unbareable. I am not sure why i wrote you. I guess Im hoping you can give me some good advise. I read all about you on your blog and am very impressed.Please if you can find time i would love to see what yo would suggest.I am so very sorry for takeing up alot of yor time i know your a very busy man. Have a wonderful day…………………. Hope to hear from you soon.OH Yes i forgot to mention i am a diabetic and i have multiple sclerosis .Again I hope to hear from you very soon……………… Thank You for your time. Thank You Again Janene :):):):):):):):):):):):):):):):):):):) Smile its contagious 🙂
Dear Janene,
After review of your history and examining your knee your physcisian will examine your x-rays. If these show significant loss of the cartilage in your knee and bone rubbing against bone, they may well advise you to consider a knee replacement. At 48, you are certainly younger than ideal with regard to knee replacement, bit if factors such as, cartilage loss, increasing pain and decreasing function are significant then you will have to weigh the pluses and minuses of joint replacement at an earlier age.
Regards, William Barrett