Exercise or Surgery for Knee Pain?
(HealthDay News) — Arthroscopic surgery to relieve chronic knee pain in middle-aged and older patients is only temporarily effective and might be harmful, a new analysis suggests. The report was published online June 16 in The BMJ.
In a review of 18 randomized controlled trials, Ewa Roos, PhD, a professor in the department of sports science and clinical biomechanics at the University of Southern Denmark in Odense, and colleagues compared the benefits and harms of arthroscopic surgery. Trials involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included.
Of the trials reviewed, nine reported only short-term benefits from surgery. The average age of patients in each study ranged from 50–63, and follow-up time was three to 24 months. An additional nine studies on the procedure's harms found deep vein thrombosis was the most frequent complication. Other complications included infection, pulmonary embolism, and death.
"We found you improve regardless of if you have surgery or nonsurgical treatment," Roos told HealthDay. "During the last 20 years, more than 50 randomized trials have been performed, and there is today strong evidence showing that exercise is effective treatment for knee pain." Exercise may even be a better alternative to knee replacement, Roos said; however, "total knee replacement is a very good treatment when performed at the right time on the right patient," she added.