关节镜手术很少利于膝关节炎

许多膝关节骨性关节炎患者接受手术的结果同非手术保守治疗无根本区别。 加拿大的研究人员发现: 关节镜检查手术与非手术疗法，物理疗法，病人教育和药物疗法，其中包括止痛药，葡萄糖和注射透明质酸润滑联合非手术治疗178例膝关节骨性关节炎。两年手术后，病人报告疼痛和功能相似。
Arthroscopy Scant Benefit for Knee OA

Many patients with osteoarthritis of the knee will undergo arthroscopic surgery, but the procedure is no more helpful than more conservative care, a new study has found.

Researchers in Canada compared arthroscopy with nonsurgical treatments—physical therapy, patient education and a drug regimen that included painkillers, glucosamine and an injection of hyaluronic acid to lubricate the joint—in 178 patients with knee osteoarthritis. Two years after surgery, patients who underwent the procedure reported levels of pain and functionality similar to those in the group that received the physical therapy and drug regimen, according to the researchers, from the University of Western Ontario.

The results, reported in the September 11 issue of The New England Journal of Medicine (2008;359:1097-1107) “call into question the widespread use of arthroscopic treatment for osteoarthritis of the knee,” the researchers wrote.

“Although some may argue that treatment is beneficial for patients with mechanical symptoms of catching or locking or those with early disease, prespecified subgroup analyses also failed to show efficacy in this population of patients.” The study excluded patients suspected of having large meniscal tears, who would be considered good candidates for arthroscopy, they added.