Exercise therapy is more beneficial than arthroscopic surgery in older knee patients

Exercise therapy is more beneficial than arthroscopic surgery in older knee patients Arthroscopic surgery in middle-aged and older patients is ‘difficult to justify’ Picture credit: SPL Researchers reviewed the results of 18 studies on the benefits and harms of arthroscopic surgery for knee pain in patients with and without osteoarthritis compared with control treatments ranging from placebo surgery to exercise. The average age of patients ranged from 48 to 63 years, with follow-up time between three and 24 months. Overall, surgery was associated with a small but significant effect on pain at three and six months, but no longer, compared with control treatments. No significant benefit on physical function was found. A further nine studies reporting on harms found that, although rare, deep vein thrombosis was the most frequently reported adverse event, followed by infection, pulmonary embolism and death. The researchers point out that the benefit from arthroscopy was ‘markedly smaller than that seen from exercise therapy’. They conclude that the findings do not support arthroscopic surgery as a treatment for this group of patients. In a related editorial ( www.bmj.com/cgi/doi/10.1136/bmj.h2983 ), Andy Carr from the Oxford University Institute of Musculoskeletal Sciences, says: ‘It is difficult to justify a procedure with the potential for serious harm, even if it is rare, when that procedure offers patients no more benefit than placebo.’ http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Nursing Standard Royal College of Nursing (RCN)

Exercise therapy is more beneficial than arthroscopic surgery in older knee patients

Nursing Standard, Volume 29 (43) – Jun 24, 2015

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Publisher
Royal College of Nursing (RCN)
Copyright
©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
Subject
Clinical digest
ISSN
0029-6570
eISSN
2047-9018
DOI
10.7748/ns.29.43.15.s18
Publisher site
See Article on Publisher Site

Abstract

Arthroscopic surgery in middle-aged and older patients is ‘difficult to justify’ Picture credit: SPL Researchers reviewed the results of 18 studies on the benefits and harms of arthroscopic surgery for knee pain in patients with and without osteoarthritis compared with control treatments ranging from placebo surgery to exercise. The average age of patients ranged from 48 to 63 years, with follow-up time between three and 24 months. Overall, surgery was associated with a small but significant effect on pain at three and six months, but no longer, compared with control treatments. No significant benefit on physical function was found. A further nine studies reporting on harms found that, although rare, deep vein thrombosis was the most frequently reported adverse event, followed by infection, pulmonary embolism and death. The researchers point out that the benefit from arthroscopy was ‘markedly smaller than that seen from exercise therapy’. They conclude that the findings do not support arthroscopic surgery as a treatment for this group of patients. In a related editorial ( www.bmj.com/cgi/doi/10.1136/bmj.h2983 ), Andy Carr from the Oxford University Institute of Musculoskeletal Sciences, says: ‘It is difficult to justify a procedure with the potential for serious harm, even if it is rare, when that procedure offers patients no more benefit than placebo.’

Journal

Nursing StandardRoyal College of Nursing (RCN)

Published: Jun 24, 2015

References

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