ARTHROSCOPY FOR MILD-MODERATE KNEE OSTEOARTHRITIS NO BENEFIT OVER MEDICAL RX

A new Canadian university  study (Kirkley 2008)  randomized some 170  patients with mild-to-moderate osteoarthritis  to arthroscopic debridement AD  of the knee or noninvasive medical – physical therapy. After 2 years of followup there was no signifiant difference in outcome between the operated and those treated conservatively. 

In 2008 so far, while there is no question of the value of arthscopic intervention for severe or blocked cases, especially in professional  eg “sports” workers, expert reviews conclude: 
 London University  (Axford   ” the treatment of depression and pain may be paramount to the successful treatment of knee OA”.
 
from New York (Lementowski 2008) focusses on the importance of reversing obesity.
 
from Israel (Bloom) “Osteoarthritis (OA) is the leading cause of knee morbidity. Age and overweight are the main risk factors for development of knee OA. The majority of patients respond to conservative treatment”
 
a Thailand Cochrane review of arthroscopic debridement (Laupattarakasem) found “There is ‘gold’ level evidence that AD has no benefit for undiscriminated OA (mechanical or inflammatory causes).
 
Creighton University (Gregory) concluded “most research suggests that glucosamine plus chondroitin  sulfate can improve symptoms of pain related to osteoarthritis, as well as slow disease progression in patients with osteoarthritis of the knee.  S-adenosylmethionine may reduce pain but high costs and product quality issues limit its use. Several other supplements are promoted for treating osteoarthritis, such as methylsulfonylmethane MSM, devil’s claw, Curcumin and ginger”,.
We have recently reviewed below (12 April, 24 June)  the good evidence that combined chondroglucosamine after a  few months reverses apparently intractible OA of the knees. Until the joint re-surfacing with  cartilage kicks in, natural analgesic antiinflammatories and overweight-reducing antidepressants  eg fish oil plus  5HTP plus MSM-curcumin-cat’s claw- bromelain-boswelia – pantothenic acid should be taken.

 

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