People who exercise for three months had similar levels of muscle strength and function as those who had knee arthroscopy, a form of keyhole surgery.
Although knee arthroscopy is routine, with around two million procedures performed every year around the world, the results are poor, and the patient doesn’t see much improvement.
Researchers from the Martina Hansens Hospital in Norway decided to test the procedure against a supervised exercise programme, involving a group of 140 people who had meniscal tears. Half had arthroscopy, followed by simple daily exercises at home, and the rest had a three-month programme of supervised exercises two to three times a week.
At the end of the three months, there was no clinical difference between the two groups, and pain, function, muscle strength and quality of life was similar. Interestingly, 13 in the exercise-only group later decided to opt for surgery, but they didn’t see any improvement.
In an accompanying editorial, Teppo Jarvinen at the University of Helsinki and Gordon Guyatt at McMaster University in Canada ask how a surgical procedure could become so popular and widespread when there is little or no supporting evidence that it actually works. “Essentially, good evidence has been ignored”, they write.