Several thousand patients a year in the UK have Arthroscopic procedures – keyhole surgery, either on the NHS or privately. One of its indications is to reduce knee pain caused by Osteoarthritic changes in the knee by tidying up damaged cartilage and ligaments or removing loose debris and floating bits of cartilage from inside the joint. The operation involves making two small cuts on either side of the front of the knee. One is for a telescope – Arthroscope, enabling the surgeon to see directly inside the area, and the other is for instruments to carry out the surgery.
Researchers in America compared real surgery in 180 patients with a placebo group of patients in which the patients were given an anaesthetic to make them fall sleep and a local anaesthetic to make the skin incisions. In the placebo group the surgeons did not go into the knee joint.
All the patients reported reduced pain and better knee function, and there was no real difference in outcome between those who had real surgery and those who got the dummy or placebo procedure at the two year follow up.
For the younger non arthritic patient with ligament or cartilage damage there is still a strong case for keyhole surgery, but this new research may start to alter current thinking of using keyhole surgery as intermediate line of attack for the Osteoarthritic joint to one of a just recommending a partial or full knee replacement.