Friday, 18 Jan 2019

You are here

No Arthroscopy Needed for Degenerative Knees and Meniscal Tears

The British Medical Journal has published a clinical practice guideline for the use of arthroscopic surgery for degenerative knee arthritis and meniscal tears, suggesting that many patients will not benefit from such surgery. (Citation source http://buff.ly/2pNhgug)

Reuters reports that globally, > 2 million people annually will have arthroscopic surgery for degenerative knees. These new guidelines recommend against for most patients with knee arthritis arthritis.

In the US the annual cost of arthroscopic knee surgery is nearly $3 billion, and although the risk of serious adverse events is low, its utility was questioned by an multidisciplinary panel who reviewed data from 13 randomized controlled trials.

In the end, the panel strongly recommended against arthroscopy based on a low probability (15%) of improving short-term pain and function that does not last for a year. This is in addition to the burden/pain experienced postoperatively and rare risk of serious adverse effects associated with knee arthroscopy. 

Experts suggest that  intraarticular corticosteroids, physical therapy and anti-inflammatory medications are as effective as surgery for degenerative meniscal tears,

 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

FDA Panel Backs Approval of Romosuzumab for Osteoporosis

The US Food and Drug Administration’s advisory committee on Bone, Reproductive and Urologic Drugs voted Wednesday in favor of approving Amgen’s osteoporosis anti-sclerostin drug, romosozumab (Evenity) for use women with postmenopausal osteoporosis. 

Reuters reports that the panel voted 16-1 in favor of the monthly injection developed jointly by UCB.

Heberden’s Nodes Predict Knee OA Progression

Hand and knee osteoarthritis are considered to be clinically and pathogenically different and distinct, but a new study suggests that Heberden's nodes (HNs) can predict MRI‐based knee osteoarthritis (OA) progression.

An NIH study of 575 subjects included clinical examination with evaluation of HNs at baseline and knee MRI at baseline and 24‐month.

NEJM Review - Glucocorticoid-Induced Osteoporosis

Lenore Buckley and Mary Humphrey have published a nice review of glucocorticoid-induced osteoporosis (GIOP) in the NEJM.

Uncertain Long Term Efficacy in Trials of Knee Osteoarthritis

A systematic review and network meta-analysis of 47 randomized clinical trials in knee osteoarthritis finds uncertainty around estimates of effect size for pain scores thereby casting uncertainty over the long-term efficacy of medications for knee osteoarthritis.

Zolendronate Protects Against Fracture in Osteopenia

The NEJM reports that the use of zoledronate significantly reduces the risk of nonvertebral or vertebral fragility fractures in women with osteopenia.

While it is known that bisphonates have beneficial effects in osteoporosis, their impact in osteopenia has not been shown.