Very few patients with degenerative knee disease can benefit from arthroscopic procedures, experts say today.
There is "no evidence" that surgery benefits any patients with these knee problems, according to the report in The BMJ.
The experts say that most guidelines wrongly support the use of arthroscopy in several sub-groups, such as those with meniscus tear, mild to moderate movement problems and sudden onset of symptoms.
They cite a trial that reported last year showing that exercise therapy is as good as surgery for meniscus tear.
The panel of orthopaedic surgeons, physiotherapists, clinicians and patients was led by Reed Siemieniuk, of McMaster University, Ontario, Canada.
They say the evidence is so strong that performance measures and funding should be tied to "non-use" of arthroscopy.
Panel member Casey Quinlan said: “Knee arthroscopy has been oversold as a cure-all for knee pain.
"Participating in the working group that developed this guideline allowed for actual patient experience to be considered – mine was nowhere near what I had been told it would be, function and pain level were only marginally improved – giving real outcomes as a basis for the recommendations."
Rapid Recommendations: Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline BMJ 11 May 2017 [abstract]
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