Friday, December 27, 2013

More Unnecessary Surgery: Arthroscopy for a Torn Meniscus

The latest discovery about all the billions we waste on surgery that does no good:
A popular surgical procedure worked no better than fake operations in helping people with one type of common knee problem, suggesting that thousands of people may be undergoing unnecessary surgery, a new study in The New England Journal of Medicine reports.

The unusual study involved people with a torn meniscus, crescent-shaped cartilage that helps cushion and stabilize knees. Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the United States, performed, the study said, about 700,000 times a year at an estimated cost of $4 billion. . . .

The volunteer patients in the Finnish study all received anesthesia and incisions. But some received actual surgery, others simulated procedures. They did not know which. A year later, most patients in both groups said their knees felt better, and the vast majority said they would choose the same method again, even if it was fake.
I have a torn meniscus; I have a little piece of cartilage floating around on my knee that you can feel with your fingers. But fortunately for me, the first doctor I asked about it told me to leave it alone, and I did, and over the past 22 years it has not given me any trouble at all. As this guy says:
“Take 100 people with knee pain; a very high percentage have a meniscal tear,” said Dr. Kenneth Fine, an orthopedic surgeon who also teaches at George Washington University. “People love concreteness: ‘There’s a tear, you know. You have to take care of the tear.’ I tell them, ‘No. 1, I’m not so sure the meniscal tear is causing your pain, and No. 2, even if it is, I’m not sure the surgery’s going to take care of it.”

Dr. Fine added: “Yours truly has a meniscal tear. It just causes pain. I’m not having any mechanical symptoms; my knees are not locking. So I’m not going to let anybody operate.”

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