(English) Episode 75-Rethinking Knee Pain - Why Common Surgery Isn't the Go-To Fix for Degenerative Knees

This clinical practice guideline provides strong recommendations against arthroscopic surgery for nearly all patients with degenerative knee disease, including those with or without imaging evidence of osteoarthritis, mechanical symptoms, or sudden symptom onset. The panel's conclusions are based on linked systematic reviews, including a randomized controlled trial that found knee arthroscopy was no better than exercise therapy for degenerative meniscal tears. Despite being the most common orthopedic procedure globally, costing billions annually, the guideline emphasizes that arthroscopic surgery offers no important long-term improvement in pain or function, with any minor short-term benefits being transient and not sustained. The source highlights that the burden of undergoing the surgery and the associated risks outweigh the minimal potential benefits, leading to a recommendation that healthcare providers and administrators should view non-use of this procedure as a quality indicator.(Siemieniuk RAC, Harris IA, Agoritsas T, Poolman RW, Brignardello-Petersen R, Van de Velde S, et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ [Internet]. 2017;357:j1982. Available from: http://dx.doi.org/10.1136/bmj.j1982)