#simulated surgery

A controversial new study from Finland examined the effectiveness of knee surgery on those with a torn meniscus – a cartilage in the knee. Every year 700,000 people in the United States alone undergo this type of surgery, accruing up to $4 billion in medical costs.  Both patients and physicians believe that this knee surgery has long-term benefits and cite the surgery for its effectiveness.

The new study chose to challenge this assumption by taking 146 patients who were candidates for the surgery and splitting them into two groups.  One group of patients were given the surgery.  The other group of patients were led to believe they had received the surgery.

The surgery, a partial meniscectomy, involves making incisions in the knee so a small video camera can be inserted to view tears.  After the tears are confirmed and located, the surgeons trim and removed the torn parts of the meniscus. The group that did not receive the surgery were informed ahead of time that they might not receive it and agreed to both the study and any procedures the physicians would need to go through to adequately convince the patients that they had in fact received the surgery.   This control group did receive anesthesia, the incisions in the knee, and also the video procedure to show the tears, but their knee cartilage was never altered.

The end results of the two different procedures were comparable.  Patients that did receive the surgery had better results early on, with less pain after exercising and slightly better quality-of-life.  But after a year the results of the patients who had and those who had not received the surgery were virtually indistinguishable.  There were no long-term benefits to receiving the surgery. Still, many doctors recommend this surgery despite this study and a previous study suggesting physical therapy results were equivalent to surgery results for this particular procedure.

The study has received some criticism because of its small size.  However studies that involve simulated surgeries are often limited in size due to the inherit risks that come with the simulated surgeries like infections.