Editorials

Arthroscopic surgery for knee pain

BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i3934 (Published 20 July 2016) Cite this as: BMJ 2016;354:i3934
  1. Teppo L N Järvinen, professor1,
  2. Gordon H Guyatt, distinguished professor2
  1. 1Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
  2. 2Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
  1. Correspondence to: T L N Järvinen teppo.jarvinen{at}helsinki.fi

A highly questionable practice without supporting evidence of even moderate quality

With 150 000 knee arthroscopies carried out in the United Kingdom each year, and about five times that number in the United States,1 2 arthroscopic partial meniscectomy—keyhole surgery for middle aged to older adults with knee pain to trim a torn meniscus—is one of the most common surgical procedures. Considering the enormous volume, it is natural to think that there is compelling evidence for the procedure being beneficial. Remarkably, this is not so.

It is barely a decade since the publication of the first controlled trial addressing knee arthroscopy using placebo surgery as a comparator.3 Since then a series of rigorous trials, summarised in two recent systematic reviews and meta-analyses, provide compelling evidence that arthroscopic knee surgery offers little benefit for most patients with knee pain.4 5 The latest …

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