Surgery may not improve symptoms of mild to moderate knee osteoarthritis

Current evidence does not support – or oppose – the use of surgery in mild to moderate knee osteoarthritis, according to a Cochrane review of the data.

Osteoarthritis affecting the knee is common and encompasses early cartilage thinning to full-thickness cartilage loss, bony erosion and deformity.

Scientists assessed the benefits and harms of surgical intervention for the management of mild to moderate knee osteoarthritis. Outcomes of interest included pain, function, radiographic progression, quality of life, short-term serious adverse events, re-operation rates and withdrawals due to adverse events.

The reviewers found that there is a lack of good quality research; in fact, they discovered no placebo-or sham-controlled trials of surgery in people with symptomatic mild to moderate knee osteoarthritis.

Looking at the five studies involving 566 participants that were identified as eligible for the review, the reviewers established there may be no evidence of a difference between arthroscopic partial meniscectomy surgery and a home exercise programme for the treatment of this condition.

Similarly, there may not be any benefit of arthroscopic surgery over other non-surgical treatments including saline irrigation and hyaluronic acid injection, or one type of surgery over another. They conclude that “there is uncertainty around the current evidence to support or oppose the use of surgery in mild to moderate knee osteoarthritis.”

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