Knee osteoarthritis is a common condition leading to pain and disability among many middle and older aged adults.  While Physical Therapy remains a hallmark of conservative care, knee arthroscopic surgery continues to be one of the most common orthopedic surgeries.  We have previously written about the inability of arthroscopic surgery to be shown more effective than a placebo surgery for both degenerative meniscal tears and knee osteoarthritis. New guidelines published in the British Medical Journal now recommend against this procedure for “nearly all” patients with these conditions. 

The British Medical Journal reviewed the available evidence on knee arthroscopic surgery and knee pain before having an international panel provide recommendations on its’ use (Siemieniuk et al. BMJ 2017).  The panel reported the short term gains in pain and function are outweighed by the cost, post operative functional loss, and risk of adverse events.  The procedure has not been shown to improve long term pain and function.  The authors went further and reported conservative treatment including Physical Therapy should be provided for nearly all patients with degenerative knee pain including osteoarthritis and meniscal tears.