Osteoarthritis, a degenerative joint disease, is the most common form of arthritis, and commonly occurs in the knee. About 12 percent of Americans aged 65 and older have osteoarthritis of the knee. Symptoms include pain, stiffness, and swelling. Arthroscopic surgery is often recommended when first-round treatments fail.

Arthroscopic knee surgery (sometimes referred to as orthroscopic knee surgery) involves making three small incisions in the knee. A thin instrument is inserted to allow surgeons to see the joint. The surgeon will then either flush debris from the knee (arthroscopic lavage) or shave rough areas of cartilage from the joint and then flush debris from the knee (arthroscopic debridement).

Arthroscopy was once a diagnostic tool used primarily for planning a standard knee replacement surgery. The development of new instruments and advanced surgical techniques moved this procedure from diagnostic to a minimally invasive treatment for knee arthritis.

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Arthroscopic (orthroscopic) knee surgery is performed on about 650,000 people every year, at a cost of about $5,000 per procedure. Yet despite the popularity of this knee surgery, its effectiveness is not well documented. In fact, one recently published study shows that this $3 billion per year procedure works no better than a placebo procedure in which patients were sedated while surgeons pretended to operate.

The study compares arthroscopic knee surgery to placebo surgery. The 180-patient study had three groups. One group underwent arthroscopic debridement, the second underwent arthroscopic lavage and the third underwent placebo arthroscopic surgery.

Before surgery, neither the patient or medical staff knew if the arthroscopic surgery was real or fake. After the patient was on the operating table, the performing doctor opened a sealed envelope informing him either to perform a real arthroscopic surgery or a fake surgery. When performing the fake arthroscopic surgeries, the doctor made small cuts in the patients� knees to simulate an operation. The doctor then bent the knee and asked for surgical instruments. An assistant sloshed water in a bucket to make the sound of a knee being flushed, just in case the patient was partly conscious.

All patients received pain-killers and none underwent physical therapy after their actual arthroscopic surgery or fake arthroscopic surgery.

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Throughout two years of follow up, the patients in this study were unaware of whether they received real or placebo surgery. During two years of follow-up, all patients reported modest improvements in pain and the ability to walk and climb stairs. The surgery group did not reported less pain or better function than the placebo group. In fact, the placebo patients reported better outcomes than the surgery patients at certain points during follow-up.

It is believed that the placebo group did so well because they were spared the trauma of surgery.

This study challenges the usefulness of one of the most common medical procedures done for osteoarthritis of the knee and also demonstrates the power of the placebo effect.

Hyaluronate acid injections are another knee osteoarthritis treatment gaining in popularity. Osteoarthritis knee sufferers are best suited forgoing surgery and injections and concentrating on healthful measure to eliminate arthritis pain.

Arthritin, of course, is a top choice. The all-natural Arthritin safely eliminates pain without the side effects of arthritis medication and without the dangers of ineffective surgery. Moderate exercise is also beneficial for knee osteoarthritis. Remember, knee surgery should always be considered a last resort.

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