Featured Research

from universities, journals, and other organizations

Study Finds Common Knee Surgery No Better Than Placebo

Date:
July 12, 2002
Source:
Baylor College Of Medicine
Summary:
Patients with osteoarthritis of the knee who underwent placebo arthroscopic surgery were just as likely to report pain relief as those who received the real procedure, according to a Department of Veterans Affairs (VA) and Baylor College of Medicine study published in the July 11 New England Journal of Medicine.

HOUSTON (July 10, 2002) -- Patients with osteoarthritis of the knee who underwent placebo arthroscopic surgery were just as likely to report pain relief as those who received the real procedure, according to a Department of Veterans Affairs (VA) and Baylor College of Medicine study published in the July 11 New England Journal of Medicine.

The researchers say their results challenge the usefulness of one of the most common surgical procedures performed for osteoarthritis of the knee.

"The fact that the effectiveness of arthroscopic lavage or debridement in patients with osteoarthritis of the knee is no greater than that of placebo surgery makes us question whether the dollars spent on these procedures might not be put to better use," said lead investigator Dr. Nelda P. Wray, a health services researcher at the Houston VA Medical Center and Baylor College of Medicine in Houston.

In the study, 180 patients with knee pain were randomized into three groups. One group received debridement, in which worn, torn, or loose cartilage is cut away and removed with the aid of a pencil-thin viewing tube called an arthroscope. The second group underwent arthroscopic lavage, in which the bad cartilage is flushed out. The third group underwent simulated arthroscopic surgery; small incisions were made, but no instruments were inserted and no cartilage removed.

Dr. Bruce Moseley, a clinical associate professor of orthopedics at Baylor, recruited all the patients in the study and performed all surgeries both real and placebo. Dr. Baruch Brody, director of the Center for Medical Ethics and Health Policy at Baylor, was instrumental in critically assessing the ethical issues involved in the study and in developing the stringent consent process for the study.

Of the 324 participants who met inclusion criteria for the study, 44 percent declined to participate, demonstrating they understood that they might not receive the actual surgery. Before undergoing surgery, participants also wrote in their chart, "On entering this study, I realize that I may receive only placebo surgery. I further realize that this means that I will not have surgery on my knee joint. This placebo surgery will not benefit my knee arthritis."

During two years of follow-up, patients in all three groups reported moderate improvements in pain and ability to function. However, neither of the intervention groups reported less pain or better function than the placebo group. Indeed, the placebo patients reported better outcomes than the debridement patients at certain points during follow-up. Throughout the two years, the patients were unaware of whether they had received real or placebo surgery.

In past clinical trials of arthroscopic knee surgery, the majority of patients reported pain relief. Though others have suggested that improvement results from flushing out of the knee joint or the removal of cartilage, these studies did not compare the actual procedures to placebo. The authors of the new study say their findings raise questions about what really causes the improvements seen with lavage or debridement. Their results suggest the same therapeutic benefits may be achieved through non-invasive placebo surgery.

Osteoarthritis, a degenerative joint disease, is the most common form of arthritis, and commonly occurs in the knee. Symptoms include pain, stiffness, and swelling. Treatment typically involves pain-relieving and anti-inflammatory drugs, along with heat-therapy and exercise. When these fail, surgery is often recommended. In the United States, it is estimated that more than 650,000 arthroscopic debridement or lavage procedures are performed each year, many of these for arthritis, at a cost of about $5,000 each.

"This study has important policy implications," Wray said. "We have shown that the entire driving force behind this billion dollar industry is the placebo effect. The health care industry should rethink how to test whether surgical procedures, done purely for the relief of subjective symptoms, are more efficacious than a placebo."

The research was funded by VA and conducted through the agency's Houston Center for Quality of Care and Utilization Studies, based at the Houston VA Medical Center. The Center is co-funded by the department of medicine at Baylor.


Story Source:

The above story is based on materials provided by Baylor College Of Medicine. Note: Materials may be edited for content and length.


Cite This Page:

Baylor College Of Medicine. "Study Finds Common Knee Surgery No Better Than Placebo." ScienceDaily. ScienceDaily, 12 July 2002. <www.sciencedaily.com/releases/2002/07/020712075415.htm>.
Baylor College Of Medicine. (2002, July 12). Study Finds Common Knee Surgery No Better Than Placebo. ScienceDaily. Retrieved September 20, 2014 from www.sciencedaily.com/releases/2002/07/020712075415.htm
Baylor College Of Medicine. "Study Finds Common Knee Surgery No Better Than Placebo." ScienceDaily. www.sciencedaily.com/releases/2002/07/020712075415.htm (accessed September 20, 2014).

Share This



More Health & Medicine News

Saturday, September 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com
How The 'Angelina Jolie Effect' Increased Cancer Screenings

How The 'Angelina Jolie Effect' Increased Cancer Screenings

Newsy (Sep. 19, 2014) Angelina's Jolie's decision to undergo a preventative mastectomy in 2013 inspired many women to seek early screenings for the disease. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins