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In a study of 180 patients with osteoarthritis of
the knee, Houston surgeons found that those
who received "sham" arthroscopic surgery reported
as much pain relief and improved mobility as patients who
actually underwent the procedure.
In fact, the group that did not receive
surgery reported better short-term functioning compared with
the other patients.
It has been unclear why arthroscopic
surgery for knee osteoarthritis helps some people with
the condition. Dr. Moseley and his colleagues at Baylor College
of Medicine, in Houston, decided to test whether arthroscopic
surgery might be associated with a placebo effect.
After 2 weeks, patients assigned to sham
surgery were doing better than the true surgery patients --
probably, Dr. Moseley said, because they had been spared the
trauma of surgery. After 2 years, the groups had made similar
gains in walking and stair climbing, and their pain had eased
to comparable degrees.
Because all patients received pain-killing
drugs and none underwent physical therapy after their actual
or sham surgery, Moseley credited the placebo effect for helping
the sham-surgery group. "I was surprised," he said,
noting that when colleagues first proposed the possibility
to him, he discounted it.
While this research is not the final word
on arthroscopic surgery for knee arthritis, Dr. Moseley said
it does suggest it may be time for surgeons to take a closer
look at it.
"We, as surgeons,"
he said, "may need to put our time into finding better
and more effective treatments."
Annual Meeting Of The
American Academy of Orthopedic Surgeons San Francisco March 1, 2001
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