KNEE ARTHRITIS - General principles of managing Osteoarthritis of the knee :
Re: placebo knee surgery - - Posted by Iona_-Uk (Iona_-Uk), 17 September 2002
Hiya
I have read this article before in Uni and I found it very interesting.
It's certainly interesting but whether it has much effect on the frequencies of surgeries for OA in the knee remains to be seen.
I think myself, that this is a case where people go in to surgery, so desparate for relief that they will believe that they have been treated purely because they have gone to theatre and so will get a decent result. Also positive attitude helps no end and if they believe they had had surgery and there has been an effect, leave them to it and don't tell them otherwise!.
My Grandmother participated in a placeb drug trial for high blood pressure drugs and those who were taking placebos came out better than those taking the real drug.
It's so intersting but I'm not quite sure if the surgery if fair, to be brutal, I mena, I wouldn't be too happy if i turned out to have had placebo surgery!. I'm also concenred that surgeons wouldnow tell patients that thier knee pain is in thier minds?
Iona xx
Posted by Janet (Janet), 18 September 2002
I read the "official" response to this study in the Medscape Orthopaedic Journal. They said most OS's are ignoring this study. The patients were not screened the way regular patients would be. Some of the patients in the study were not even candidates for the surgery in the first place. (At least I think I remember this correctly. I just know they were really downplaying the study.)
It was interesting to read the other side of the argument. It all comes down to finding a doctor you trust and believing they will do the best thing for you.
Posted by hmaxwell (Heather M.), 18 September 2002
I have to weigh in with Janet and give the study a full dose of skepticism. A lot of the surgical patients should not have been having arthroscopy because of their age, sedentary lifestyle, and degree of arthritic damage. If you read the official paper, the average participant age was 74.
In addition, the study had, I believe, under 200 participants. But in the US alone the population with osteoarthritis tops 10 million people, so it's not a statistically significant sample. You just can't draw conclusions from the study group and apply them to the general population with OA. It might indicate the need for further study, but that's about it....
My theory is that even if the study results were treated as gold (which they were not), what's good or not good for a 74+ year old person is not necessarily going to fly in my 32 year old body....Finally, how can they say that the relief of getting a loose body out of your knee is not quantifiable or the results any better than the placebo group
That's crazy. If there's something bad floatin around in your knee, it will make you miserable. I know.
And don't even get me started on the ethics of doing a fake surgery--prepping someone, knocking them out, then cutting into their knee with no intention of doing anything else. If I'd found out I was part of the control group, I would have gone back and busted my surgeon's kneecaps.....
My two cents' worth. 
Heather
Posted by Say (Say), 20 September 2002
Helen said:
"And don't even get me started on the ethics of doing a fake surgery--prepping someone, knocking them out, then cutting into their knee with no intention of doing anything else. If I'd found out I was part of the control group, I would have gone back and busted my surgeon's kneecaps..... "
Eh, according to that article, everyone who took part in the study knew there was a chance that they could get a placebo - and furthermore, the people selected had the opportunity to opt out (and thus ensure they would get actual surgery).
Updated Thu Apr 29 2010
