Contemplating crutches or a walker after that knee surgery? Ask questions of your surgeon and make sure the operation is truly necessary.This article in the New England Journal of Medicine reports on the success of a type of arthroscopic knee surgery frequently done for a common cause of knee pain, a tear in one of the knee cartilages called the meniscus. Tears were due to degeneration rather than an acute injury.Routine arthroscopic surgery was compared to sham surgery. Incredibly this means that a scope was put into the knee to mimic an operation but nothing was done to the cartilage. Patients had to agree to not know which procedure each was given, the real or the sham one. This allows for "blinding" meaning when the patient is asked how he is doing in 12 months, he will not be biased by knowing which thing was done to his knee. Nor do the evaluators of the outcome know, so the study is actually termed "double blind".The result? No difference in outcome. Asking for proof that a procedure is likely to work is always a good thing. And it may save you some recovery time and money.Ken Elam, MD
