Warning against unnecessary knee surgery

The evidence shows arthroscopic knee surgery is relatively ineffective in treating osteoarthritis, says Australia's peak rheumatology body.

Arthroscopic knee surgery to treat osteoarthritis is of "low value" and doctors are being told to consider alternatives such as exercise therapy to avoid unnecessary harm to the patient.

The advice is one of five recommendations released on Tuesday by the Australian Rheumatology Association (ARA), one of the Royal Australasian College of Physicians (RACP) specialty societies.

Arthroscopy is used to treat osteoarthritis of the knee and can involve washing out the joint or cleaning up the lining.

A growing body of evidence suggests surgery to treat knee osteoarthritis is often not the best option, says Professor Rachelle Buchbinder from the ARA.

"The research shows that arthroscopic surgery for knee osteoarthritis does not seem to affect a patient's outcome and in some cases, the procedure can actually do more harm than good," Professor Buchbinder said.

Despite this, the data shows 43,000 Medicare Benefit Scheme-funded arthroscopic knee surgeries were performed in the 2016-2017 financial year.

Professor Buchbinder says doctors and their patients should be considering the benefits and risks of this procedure, and discussing alternatives before performing such surgery, especially for those over the age of 50.

Among the other recommendations is advice against undertaking imaging for low back pain in patients without indications of a serious underlying condition.

The ARA says most episodes of low back pain, 90 per cent, do not require imaging which increases the risk of a patient's exposure to unnecessary, and sometimes invasive treatment.

The recommendations have the support of the Consumer Health Forum of Australia.

"We want the system and patients to be paying for treatments that get the best outcome for people," Leanne Wells, CEO of CHF said.

"We don't want to see arrangements where procedures continue to be performed for years despite a dearth of evidence of their benefit."

Published 6 February 2018 at 11:06am
Source: AAP