‘Abandon bandwagon of routine knee arthroscopy’
Biological injections can banish pain.
By : DC Correspondent
Update: 2015-12-18 08:02 GMT
Chennai: If your orthopaedic surgeon recommends knee arthroscopy to cure your painful knee, then think twice. This commonest key hole surgery recommended for people with knee arthritis in Chennai and rest of the country may not appear to be a sure cure, if the claim of the acclaimed Acta Orthopedia, Scandinavia, is to be believed. An editorial published in the December issue of Acta Orthopedia Scandinavia, cautions that it may be better to abandon the bandwagon of routine knee arthroscopy. Quoting various research papers, the editorial noted that although the incidence of arthroscopy for osteoarthritis decreased over time, the corresponding incidence for degenerative meniscus tears was essentially the same at the beginning and the end of the observation period, both in Finland and in Sweden. In Finland, the incidence of arthroscopic surgery for traumatic tears increased over time, but it remained stable in Sweden. Of further note was that every second meniscal tear was coded as traumatic in Finland, while the corresponding proportion in Sweden was 1 in 4.
Reacting, Chennai’s orthopaedic surgeon Dr. A.K. Venkatachalam, claims biological injections will serve better to banish the pain. “A new mode of orthopaedic treatment with biologicals is least invasive and effective to treat early knee arthritis, undisplaced meniscal and ACL tears and relieve pain,” he says. This keyhole knee surgery for a meniscus tear for middle aged or elders is not the ideal option, as the tear seen on MRI has nothing to do with your knee pain. Citing a case, he said Chennai scientist Jayaram Rao with knee pain was advised keyhole surgery. This avid trekker didn’t want to loose his knee mobility. “Instead he opted for a biological treatment in June. One month later his pain was gone and his knee score had improved. During six month follow up now, he reconfirmed that his pain was gone but he felt some crackling noise. He is however quite happy to have undergone this injection procedure rather than a keyhole surgery,” Dr Venkatachalam claimed.
Despite strong evidence published in the New England Journal of Medicine in 2002, both orthopedic surgeons and public unaware of this fact, proceed with wash out and cleaning up of the knee on mere MRI reports of undisplaced meniscal tears. They are merely treating shadows on MRI scans and not the real problem of pain as undisplaced meniscal tears don’t cause pain. The results of these surgeries like “cleaning up the knee” and “repairing” or “trimming” a meniscus” have been dismal, basically showing that these surgeries don’t work. Other irrelevant considerations may be at work here like hospital policy to increase surgery rates, insurance compensation etc. The latest paper echoes the pioneering research by Mosley et all published in the New England Journal of medicine in 2002.
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