9/11/08 Arthroscopic knee surgery, the most commonly performed orthopaedic procedure in the United States, may be no better than medical or physical therapy for relieving chronic pain, according to the results of two studies published in the New England Journal of Medicine.
Researchers at the University of Western Ontario randomly assigned 178 people with moderate to severe osteoarthritis of the knee to either arthroscopic surgery, where the inside of the joint is cleaned and smoothed with the aid of a pencil-sized camera, or to a combination of medications, supplements and physical therapy. After two years, both groups reported nearly the same levels of pain, stiffness and disability.
In addition to cleaning and smoothing the inside of the knee, arthroscopic knee surgery is commonly performed to repair tears to a wedge of cartilage in the joint called the meniscus.
“What typically happens is that a doctor will get a patient with knee pain and give them an MRI [magnetic resonance imaging] scan, and they’ll find a meniscal tear,” said David T. Felson, MD, MPH, a rheumatologist with the Boston University School of Medicine.
But in a separate study in the same issue, Dr. Felson and his colleagues performed MRI scans on 991 people living in Framingham, Mass. They found that meniscal tears were common and often did not correspond to a patient’s pain. In fact, 61 percent of people who had meniscal tears in their knees reported that they had no pain, aching or stiffness during the previous month.
"I think this shows pretty persuasively that arthroscopy does not benefit osteoarthritis of the knee," Dr. Felson said.
According to the National Center for Health Statistics, more than 650,000 arthroscopic lavage and debridement (cleaning and smoothing) procedures are performed for knee pain each year in the United States, at an average cost of $5,000 each.
"The joint becomes full of all kinds of junk – cartilage, degrading materials and little strands of stuff and tiny tears in the meniscus and shards of things that are sometimes attached to the tissue," Dr. Felson said. "And the thinking was that if you cleaned that up, it would help the pain," he added.
These studies were not the first to question knee surgery, arthritis and pain relief.


































I faced a small problem in my knee one week ago,MRI opinion said:
- Torn body and posterior Horn
- Trabecular injury of the medical femoral condyle
- Garde I injury of the medical collateral ligament
- Mild knee joint effusion
First Docotor said that I need an immediat operation (viewer)
Second Docotor said that no need for operation and Physiotherapy
solve the propblem
Please advise urgent in order to act accordingly.
Reply Forward
Amanda
Fortunately, after my first knee surgery, I was told by one kind orthopedist 30 yrs. ago to avoid stairs if at all possible to extend life of my knee(s); "Take the elevator if you have a choice." Ended up moving into a rancher which I am certain has bought me time.
Another helpful piece of advice which I have followed: Decrease inflammation by eating a healthy diet (more fruits & vegetables, less meat, no trans fats) which also helps to avoid weight gain. Even 10 lb. adds significant stress to joints.
Additionally, adding healthy oils to diet helps to lubricate joints and decrease inflammation significantly (omega 3 fatty acids, like salmon, sardines, or fish oi).
Best advise mentioned in posts is to get second (or third) opinion before ANY surgery.
Good luck to all
Before the surgery, my orthropedist had me spend four months trying conservative remedies, none of which helped at all. He also warned me that I could be disappointed if it turned out that my pain was substantially caused by arthritis. Because I was aware of my injury the moment it had happened, I guessed that the pain and swelling was most likely caused by the meniscal tear and chose to go ahead with the surgery. Happily, this was correct, although he did find some arthritis in the knee during the surgery.
I'm always perplexed by studies that find no benefit from this surgery. For me it was a life(style) saver.
Prolotherapy can be perfomred by an osteopathic doctor and sometimes a naturopath. Prolo tightens up ligament laxity and often, when done correctly, improves osteoarthritis pain significantly. The pain in you joint is from surrounding tendon spasms attempting to support your joints.
Medications and surgeries provide little benefit.
Good luck,
Matt
With no risk factors I thought my "simple knee arthroscopy" for osteoarthritis and a few other problems would be a snap. I followed all the orders, looked like a prime candidate and had an excellent surgeon. Everything was fine until I threw a pulmonary embolism to my heart two days post op, lost consciousness at home and was rushed by ambulance to the ER with very little pulse and hypotensive. I spent two days in intensive care on blood thinners and bled into my knee causing intense pain that barely responded to medication. I am home now giving myself Lovanox shots and trying to regulate my Coumadin blood thinners which I may be on for 6 months. I have to be careful all the time. I made my decision to have the surgery primarily to prevent further damage to the joint surfaces but I didn't fully consider the risks. Do your research; ask your ortho how he plans to address the prevention of blood clots. Good luck to you.
Recovery all depends on the patient. You do nothing to help the recovery, you get nothing back. You need to move a rusty bolt to get it moving.
I am in so much less pain. I am not waking at night in pain. I get up and walk with no pain. Just need to heal up now. I am so glad I did this and am ready to run asap!!
I should mention I am a 47 year old fit female.
No ned to be scared of procedure for arthroscopy on left knee.
I had it done 11 years ago and the knee could not be better still.
I was an elite athlete in my younger days and really worked the legs.It was when I was merely squatting to pick up a box that the knee finally went.
Pain was severe and it blew up instantly like a puffer fish ,I had not experienced pain like it. From wear and tear of all those years of heavy training it had enough.
I must say, after surgery I was doing Christmas shopping , 3 days later but the pain was nothing I had experienced in my life . It also took months of hard work walking and swimming to get the knee doing what it used to. 11 years later it is still okay and I am exercising , but not heavy pounding the knee as i was told not to.
To top it off , 5 years after knee arthroscopy my right hip went,I denied anything was wrong and kept telling myself it was just muscle pain, it became so bad after 18months I was not sleeping any more.
Finally I had 3 orthopoedic drs tell me it was mild arthritis and it was odd that I was complaining so much about the pain, it was unbearable and all three surgeons decided to give me a new hip.
I did not accept their diagnoses and how to solve the pain, so I went to the dr who operated on me 11 yrs prior on my knee, he ran some xrays again and said he is more than sure I have a labrum tear , which is the fleshy ligament like structure between socket area of the hip.
He said he is more than 99% sure he can fix it and I will not need hip replacement.
Once again I went into surgery and it is great. Okay the bit of cushioning he cleaned up will never grow back but I am as good as new, and no hip replacement. Lots of pain worse than knee pain after surgery and took a long time to get back to normal but persistence is the key and determination to use it again .
It pays to get many opinions too.
So never fear it does work but it takes time to heal and also to be very good again.
Peggy Brandt
Unlike the majority of the people writing, I've had great results. Had a normal recovery and 2 years later my knee is 85% better than before I had the surgery done.
While I encourage people to get multiple opinions (which was something I made sure to do) I wish more people were posting positive stories because if for some reason I have knee problems like i did before, I would get the surgery done again
I had my knee arthroscope surgery 9/2010 on my left knee, which was horribly painful and brought NO relief whatsoever, had P/T for 8 weeks after that and had to quit because I needed a cane to walk for the first time in my life! I then had three shots of Euflexxa in same knee in January and was told by April 2011 that I needed the TKR anyway and was totally bone-on-bone.
Well, it's now July and here I am 9 weeks post-op from TKR and just beginning to feel better than I have in more than a year of agony. I am NOT out of the woods yet, still need pain meds, but the actual range of motion, ability to balance and take uneven surfaces, staircases, etc is I would say at least 75% better than before.
So there is hope if you have to resort to the Total Knee Replacements. Your pain becomes MANAGABLE, and with time the meds are tapered off to a reasonable level.
It is VERY hard work those first few weeks, and I will not sugar coat this, you must work for HOURS each day during the recovery time doing passive exercises, CPM (a machine which bends your leg for you) and then subsequently go to Physical Therapy and use the stationary bike and pool for many weeks. And yes the pain is unbelieveably insessant.
But it does get better. If you are a candidate for the Total Knee surgery, after trying the synovial replacement injections and still are having pain, I would skip the arthroscope and just plan for the TKR in your future. Good luck and hope this helps.
approx. 8 years later...when I was tired of limping and having a swollen knee...I went to a real Doctor whom told me I had tore my ACL and both cartaliges. I had surgery with a HMO plan I had. The doctor told me I would be back in 5 years (this was after my surgery) I have limped on this knee ever since and today it is much worse. Almost unbareable. Since I am self employed and my wife has been working in our business for 15+
years...I am the only income and this Econnomy has all but ruined us. Did I mention we are in Texas where the business is suppose to be good! I need sugery but can't afford the time off it will take to recover. does anyone have any unsarcastic suggestions? we are paying for health insurance but the time off to recover will put us under if we survive this depression!
He performed the surgery to clean up the arthritis and when he got in there, he found the ligaments and cartilage damage. I have been pain free now for 3 years. Now I am getting ready to have the right knee done. I have arthritis and bursitis really bad. Back,knees-shoulders-hips. You name it and I have it. I was very please with my surgery. I know that not all surgeons are the same, I guess I got lucky. I will let you know the outcome of the surgery on my right knee.
You have answered my questions, more than you know.
I have had problems with my left knee for some time. I have osteoartritis and some back pain. I WAS considering surgery, but having read your postings, I will not fix what is not totally broken. I still play badminton and can walk pretty good, although
my back and bending does stiffen and pain
often. I can live with it, so far.
So, once again,thanks to all of you
and good luck.
At least we can all smell the roses and get some sunshine.
I had an arthoscopy done on my left knee two years ago. Have not been able to keep my left leg straigh. am unable to walk , constantly lose my balance, got bad back pain and the Surgeon is unable to fix the problem. I am 33 yr old female whom can hardly walk. Is any one able to guide me what the next step is? I afford physio anymore , costing me about $70 for half an hour, and no improvement what so ever. Has anyone experienced the same problem?? Please please keep in touch with me, i need some advice.
Thanks
SHIMA
this brace is somewhat heavy and has to be made specifically to your measurements. lucky, my insurance co-pay is only 90.00 on this 900.00 brace. check around your area hospitals, etc., and ask about any such studies being conducted in your area. i found out about this study, and was told i could not have the brace because the study was full... until i said 'get me that brace'!!!!!!! but i am very fortunate to have good insurance. people in the study are getting the brace for free.
Please help me ASAP
Kris in Australia , Thanks heaps /
Have you been icing it and elevating it every chance you get? Also have you tried any exercise they gave you to try?
I'm also sorry to tell you that the worst is yet to come. You think you are better after 24 hours but the truth is that your knee will never be the same. Also you have brought yourself one step closer to eventually needing a total knee replacement. I had my surgery back in August 2009 and at first felt like you. Now after reading several knee related books and talking to tons of people who had this surgery I'm 100% convinced that it does much more harm than good except in an emergency. Time will reveal the unfortunate truth for you.
I LIMP I AM IN CONSTANT PAIN. MY LEG IS AS STIFF AS A ROCK, IF I LAY WITH IT STRAIGHT IT KILLS ME....I AM IN CONSTANT AGONY...AND have to watch my team play every sunday....just had a 2nd MRI scan and looks like they will operate again....I DONT CARE NOW I NEED TO HAVE ANYTHING DONE....I CANT LIVE WITH THIS PAIN ANY LONGER...I WISH I COULD TURN BACK TIME..
bfore the scop, i could run , n play sports , experienced pain ONLY after exercise,but now I'M IN AGONY,couldnt walk more without cructhes because of unbearable pain!! entire left lower limb is wasted, with hip n backpain as well.i may need to give up my job,just graduated from medical school..
surgeon suckx! my only hope now is can walk without crutches so tat i can return back to my routine..
NEVER do arthroscopy to rectify minimal cartilage wearoff n meniscal tear!
... not 2008
There are definitely many other options. Do the research carefully before committing yourself to a lifetime of pain. AND PLEASE DO YOURSELF A FAVOR AND READ MY PREVIOUS POSTS AGAIN! Best wishes.
The complete truth is that even 6 months after the surgery most normal people will still be in more pain than before the surgery!
Before the surgery I only had pain the day after playing tennis and occasionally when walking down stairs. Now I have some pain all the time. I’ve spent many many months trying physical therapy, acupuncture, heat, cold, massage and injections but nothing brings it back to normal. I can’t stay on a treadmill for more than a few minutes or I’ll have serious pain for days. My advice to everyone is to get at least 2 opinions from doctors who are NOT surgeons. Surgeons will lie just to make a quick buck. Again I repeat DO NOT GET THIS SURGERY UNLESS ABSOLUTELY NECESSARY!!!
Best wishes to all.
Nathan
Before the surgery I only had pain the day after playing tennis and usually only when walking down stairs. Now I have some pain all the time. I've spent many many months trying physical therapy, acupuncture, heat, cold, massage and injections but nothing brings it back to normal. I can't stay on a treadmill for more than a few minutes or I'll have serious pain for days. My advice to everyone is to get at least 2 opinions from doctors who are NOT surgeons. Surgeons will lie just to make a quick buck. Again I repeat DO NOT GET THIS SURGERY UNLESS ABSOLUTELY NECESSARY!!!
Colleen x
Ronald
Findrxonline.com
Had arthroscopy done 5 months ago in right knee, due to torn cartilage. The discomfort experienced before the op is nothing compared to what I have now. I can't bend my knee properly, can't kneel down on it at all. I also now walk with a limp which hurts my hip and lower back. Before the op I was also playing badminton twice a week, now it's a thought even to walk my two dogs for 10 minutes without having someone or something to support me. I've been back to the GP several times but they just keep saying it will get better and to take painkillers if it's bad. I'm only 47!
Would I have the procedure done again - a most definite NO!
I have been scoped on both knees. One 15 years ago just confirmed a minor acl tear; has been fine since. The other scope 6 years ago on an ACL repaired knee (from 1982), cleaned up some meniscus and removed the intense pain; been playing tennis again on it since. Arthritis extremely severe now, but self inflicted(?)
I question whether surgery will do anything for me at 53.
At this point (nearly a year later) I need some help or perhaps treatment. Any suggestions or help here would be greatly appreciated. Thank you for your time in reading and perhaps answering my plea for help.
Nathan
My advice is if you have a meniscal tear that needs to be fixed, find a doctor who does not provide this harmful and ruination service of so-called articular smoothing, because, trust me, it will ruin your knees. I am considering sueing my last doctor because I am much worse off after the surgery than before.
I have been reading everyone's posting. I just hope everyone feels better soon.
I do have just one question. When did everyone go back to work after tthe surgery.
There are no steriods used. Has been use over 75 years in Europe and the USA, but the insurance companies will not cover the cost of the procedure. We will see if this works. Don't know how much more pain I can endure. Check in your area about this.
I have RA but think I have "loose" cartilage or other problems in rt. knee.
What to Do?
Before the surgery doing marathons had become impossible [walk- don't run]. Actually walking up stairs without dragging my foot was not possible.
Yesterday I walked 3 miles and really did not have any pain. My goal is to do a marathon at the end of September.I will be 68 in September and only have two marathons planned before the year is over.
The overnight pain that existed before surgery is gone and I am now getting a full night of rest.
Before surgery I might have had some pain but WOW this is too much. My surgeon said wait and see 4 times to me in his surgery.
This is some kind of joke. I have been looking online and I cannot see a percentage of more than 4% of people who have benefited from this surgery. I have had to get married ON CRUTCHES how bad is that. I am in floods of tears this surgery has ruined my life.
Will never have it done again. Good luck to everyone x
Arthroscopic knee surgery can make knee pain and Ostero Arthritis worse.
I had that surgery on my left knee and it took 2 years to get out of the pain it caused.
Since then I came under the care of a rheumatoligist who has given me injections of Euflexxor, every 6 months for the past year and a half, and it has worked miricles for me. I'm out of pain and able to walk 2 miles every day and do "line dancing" without any pain.
I would NEVER have authroscopic surgery on any knee again!
My newly-operated leg felt shorter than the left one, and steps/stairs have been a challenge (especially, going down) ever since. I can't walk long without hurting (now, I need the left knee done, too)...and I need the crutch of my grandbaby's stroller handle or a shopping cart, when I do walk for any amount of time.
Like many of the above people who commented, I, too, fear having surgery on the other leg, for the possibility (or probability, in my case...diabetic, with many circulatory issues, take a baby aspirin every day) of blood clots. My friend lost her mom, at 53, three days after elective surgery, to a blood clot that travelled to her brain.
I take three Advil Liqui-Gels every morning (the earlier the better, for effectiveness), and I purchased expensive, orthotic shoes (Z-Coils are good, too). Any analgesic roll-ons, like Bio Freeze and Capzacin are temporary comforts, that help...and don't forget the ice and heat packs (I like the corn bags, that you can microwave)!!
Good luck, I am there with you!!!
I thought I was doing good, but I stand a lot at work well its June now and I am in so much Pain from all the standing, I come home so tired and rest each night with Hot or cold packs which ever works better. I have Rheumatoid Arthritis. Need to Have Knee Replacement soon. just the thought of it!!!!
I too had knee arthroscopy for a medial tear in my left knee, which was caused by running. I had surgery just over six weeks ago. My knee feels better than it ever has. I a running again as well, if not better than I was before. The surgery was painless. I made sure I did everything I was supposed to. I did all the exercises I was told to. I do think that surgery is very diffent for all types of people. I think the fitter you are before the surgery. The quicker you recover. I hope everyone who has had surgery feels great again very soon.
I am so tired of this, but hate to be whining...jeez.
lou
I had torn cartilage and arthritis. I am in much more pain now than before. Before the surgery In had pain just at one side of my knee, now its at both sides and around the back of my knee. I feel totally let down by my surgeon, I know they cant work miracles, but since looking on the internet for answers I have come across so many people who have had this procedure and are in more pain now than before. I have always been quiet when I am in his office I go see hem in a couple of months and beleive me when I go I will be letting him have it!!!!!
Messed it up on a structure fire. a year later had the left one done Horse took care of it for me. Now my right knee is so painful most of the time. On the outside of the knee right beside the knee cap I get a big knot when the swelling happens this puts me in very severe pain. When the knot is not there it is not so bad. I am getting ready to get back on a Fire Dept. So I have to do something.
I had my right knee scoped in December 8 weeks now, still bothering me.
Found out that I have arthritis, whippee! No real surprise though...sports and age, what are you to do?
Anyways, I just had my left knee done, it's 6 days post op and I still can hardly walk. When the right knee was done, I got an infection, I thought this delayed the recovery, but now with the left and it's definitely taking longer to get out of bed , I'm wishing I didn't go through with the surgery.
I had the left done about 8 yrs ago, remember it too was very painful afterwards, but eventually the pain went away and I felt better than ever. This time, not so sure what the out come is going to be...?
Still can't bend the right knee fully, still difficult going up and down stairs (before this recent surgery on my left) there was no way in.....that I could kneel on it.
Now I lie here praying for the throbbing to stop!
Did I make a mistake? I hope not. I have to believe that all will be better soon, better than before would be nice.
But I am scared, that this might of been the biggest mistake, any body have a similar outcome?
I think from now on, if I have knee pain, I try for a cortisone shot vs. surgery.
If you have arthritis, the knee will probably never fully recover.
The joy of getting older. yeah!
I have mixed emotions, the right did so well. My left however is worse than before. The pain is unbearable at times & I can't get up from sitting easily.
I have 2 young children, making it hard for me to do things with them.
I have to return to work where I am on my feet constantly, I don't sit a minute literally.
I think I would definetely do more research before having anything like this done again.
Before my surgery I had a 10 degree bend in my knee and three days after the surgery I had a 2 degree bend. That alone is enough for me to rcommend the surgery. I will walk straighter and without a limp for the first time in several years.
I'm still healing and a little sore but hopeful for a relief in knee pain for the first time in years.
http://igotnewpartsinmyknee.blogspot.com
none of them can tell me what's wrong. I was referred to sa specialist just a few weeks ago. Hopefully, he has an answer for me. I'm
also needing surgery again.
Leave a Comment