A controlled trial of arthroscopic surgery for osteoarthritis of the knee

Research output: Contribution to journalArticle

J. Bruce Moseley, Kimberly O'Malley, Nancy J. Petersen, Terri J. Menke, Baruch A. Brody, David H. Kuykendall, John C. Hollingsworth, Carol M. Ashton, Nelda Wray

Background: Many patients report symptomatic relief after undergoing arthroscopy of the knee for osteoarthritis, but it is unclear how the procedure achieves this result. We conducted a randomized, placebo-controlled trial to evaluate the efficacy of arthroscopy for osteoarthritis of the knee. Methods A total of 180 patients with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement, arthroscopic lavage, or placebo surgery. Patients in the placebo group received skin incisions and underwent a simulated débridement without insertion of the arthroscope. Patients and assessors of outcome were blinded to the treatment-group assignment. Outcomes were assessed at multiple points over a 24-month period with the use of five self-reported scores - three on scales for pain and two on scales for function - and one objective test of walking and stair climbing. A total of 165 patients completed the trial. Results At no point did either of the intervention groups report less pain or better function than the placebo group. For example, mean (±SD) scores on the Knee-Specific Pain Scale (range, 0 to 100, with higher scores indicating more severe pain) were similar in the placebo, lavage, and débridement groups: 48.9±21.9, 54.8±19.8, and 51.7±22.4, respectively, at one year (P= 0.14 for the comparison between placebo and lavage; P=0.51 for the comparison between placebo and débridement) and 51.6±23.7, 53.7±23.7, and 51.4± 23.2, respectively, at two years (P=0.64 and P=0.96, respectively). Furthermore, the 95 percent confidence intervals for the differences between the placebo group and the intervention groups exclude any clinically meaningful difference. Conclusions In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure.

Original languageEnglish (US)
Pages (from-to)81-88
Number of pages8
JournalNew England Journal of Medicine
Volume347
Issue number2
DOIs
StatePublished - Jul 11 2002

PMID: 12110735

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A controlled trial of arthroscopic surgery for osteoarthritis of the knee. / Bruce Moseley, J.; O'Malley, Kimberly; Petersen, Nancy J.; Menke, Terri J.; Brody, Baruch A.; Kuykendall, David H.; Hollingsworth, John C.; Ashton, Carol M.; Wray, Nelda.

In: New England Journal of Medicine, Vol. 347, No. 2, 11.07.2002, p. 81-88.

Research output: Contribution to journalArticle

Harvard

Bruce Moseley, J, O'Malley, K, Petersen, NJ, Menke, TJ, Brody, BA, Kuykendall, DH, Hollingsworth, JC, Ashton, CM & Wray, N 2002, 'A controlled trial of arthroscopic surgery for osteoarthritis of the knee' New England Journal of Medicine, vol. 347, no. 2, pp. 81-88. https://doi.org/10.1056/NEJMoa013259

APA

Bruce Moseley, J., O'Malley, K., Petersen, N. J., Menke, T. J., Brody, B. A., Kuykendall, D. H., ... Wray, N. (2002). A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine, 347(2), 81-88. https://doi.org/10.1056/NEJMoa013259

Vancouver

Bruce Moseley J, O'Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine. 2002 Jul 11;347(2):81-88. https://doi.org/10.1056/NEJMoa013259

Author

Bruce Moseley, J. ; O'Malley, Kimberly ; Petersen, Nancy J. ; Menke, Terri J. ; Brody, Baruch A. ; Kuykendall, David H. ; Hollingsworth, John C. ; Ashton, Carol M. ; Wray, Nelda. / A controlled trial of arthroscopic surgery for osteoarthritis of the knee. In: New England Journal of Medicine. 2002 ; Vol. 347, No. 2. pp. 81-88.

BibTeX

@article{f69d0623eca9480fae8c3b622177b533,
title = "A controlled trial of arthroscopic surgery for osteoarthritis of the knee",
abstract = "Background: Many patients report symptomatic relief after undergoing arthroscopy of the knee for osteoarthritis, but it is unclear how the procedure achieves this result. We conducted a randomized, placebo-controlled trial to evaluate the efficacy of arthroscopy for osteoarthritis of the knee. Methods A total of 180 patients with osteoarthritis of the knee were randomly assigned to receive arthroscopic d{\'e}bridement, arthroscopic lavage, or placebo surgery. Patients in the placebo group received skin incisions and underwent a simulated d{\'e}bridement without insertion of the arthroscope. Patients and assessors of outcome were blinded to the treatment-group assignment. Outcomes were assessed at multiple points over a 24-month period with the use of five self-reported scores - three on scales for pain and two on scales for function - and one objective test of walking and stair climbing. A total of 165 patients completed the trial. Results At no point did either of the intervention groups report less pain or better function than the placebo group. For example, mean (±SD) scores on the Knee-Specific Pain Scale (range, 0 to 100, with higher scores indicating more severe pain) were similar in the placebo, lavage, and d{\'e}bridement groups: 48.9±21.9, 54.8±19.8, and 51.7±22.4, respectively, at one year (P= 0.14 for the comparison between placebo and lavage; P=0.51 for the comparison between placebo and d{\'e}bridement) and 51.6±23.7, 53.7±23.7, and 51.4± 23.2, respectively, at two years (P=0.64 and P=0.96, respectively). Furthermore, the 95 percent confidence intervals for the differences between the placebo group and the intervention groups exclude any clinically meaningful difference. Conclusions In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic d{\'e}bridement were no better than those after a placebo procedure.",
author = "{Bruce Moseley}, J. and Kimberly O'Malley and Petersen, {Nancy J.} and Menke, {Terri J.} and Brody, {Baruch A.} and Kuykendall, {David H.} and Hollingsworth, {John C.} and Ashton, {Carol M.} and Nelda Wray",
year = "2002",
month = "7",
day = "11",
doi = "10.1056/NEJMoa013259",
language = "English (US)",
volume = "347",
pages = "81--88",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachusetts Medical Society",
number = "2",

}

RIS

TY - JOUR

T1 - A controlled trial of arthroscopic surgery for osteoarthritis of the knee

AU - Bruce Moseley, J.

AU - O'Malley, Kimberly

AU - Petersen, Nancy J.

AU - Menke, Terri J.

AU - Brody, Baruch A.

AU - Kuykendall, David H.

AU - Hollingsworth, John C.

AU - Ashton, Carol M.

AU - Wray, Nelda

PY - 2002/7/11

Y1 - 2002/7/11

N2 - Background: Many patients report symptomatic relief after undergoing arthroscopy of the knee for osteoarthritis, but it is unclear how the procedure achieves this result. We conducted a randomized, placebo-controlled trial to evaluate the efficacy of arthroscopy for osteoarthritis of the knee. Methods A total of 180 patients with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement, arthroscopic lavage, or placebo surgery. Patients in the placebo group received skin incisions and underwent a simulated débridement without insertion of the arthroscope. Patients and assessors of outcome were blinded to the treatment-group assignment. Outcomes were assessed at multiple points over a 24-month period with the use of five self-reported scores - three on scales for pain and two on scales for function - and one objective test of walking and stair climbing. A total of 165 patients completed the trial. Results At no point did either of the intervention groups report less pain or better function than the placebo group. For example, mean (±SD) scores on the Knee-Specific Pain Scale (range, 0 to 100, with higher scores indicating more severe pain) were similar in the placebo, lavage, and débridement groups: 48.9±21.9, 54.8±19.8, and 51.7±22.4, respectively, at one year (P= 0.14 for the comparison between placebo and lavage; P=0.51 for the comparison between placebo and débridement) and 51.6±23.7, 53.7±23.7, and 51.4± 23.2, respectively, at two years (P=0.64 and P=0.96, respectively). Furthermore, the 95 percent confidence intervals for the differences between the placebo group and the intervention groups exclude any clinically meaningful difference. Conclusions In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure.

AB - Background: Many patients report symptomatic relief after undergoing arthroscopy of the knee for osteoarthritis, but it is unclear how the procedure achieves this result. We conducted a randomized, placebo-controlled trial to evaluate the efficacy of arthroscopy for osteoarthritis of the knee. Methods A total of 180 patients with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement, arthroscopic lavage, or placebo surgery. Patients in the placebo group received skin incisions and underwent a simulated débridement without insertion of the arthroscope. Patients and assessors of outcome were blinded to the treatment-group assignment. Outcomes were assessed at multiple points over a 24-month period with the use of five self-reported scores - three on scales for pain and two on scales for function - and one objective test of walking and stair climbing. A total of 165 patients completed the trial. Results At no point did either of the intervention groups report less pain or better function than the placebo group. For example, mean (±SD) scores on the Knee-Specific Pain Scale (range, 0 to 100, with higher scores indicating more severe pain) were similar in the placebo, lavage, and débridement groups: 48.9±21.9, 54.8±19.8, and 51.7±22.4, respectively, at one year (P= 0.14 for the comparison between placebo and lavage; P=0.51 for the comparison between placebo and débridement) and 51.6±23.7, 53.7±23.7, and 51.4± 23.2, respectively, at two years (P=0.64 and P=0.96, respectively). Furthermore, the 95 percent confidence intervals for the differences between the placebo group and the intervention groups exclude any clinically meaningful difference. Conclusions In this controlled trial involving patients with osteoarthritis of the knee, the outcomes after arthroscopic lavage or arthroscopic débridement were no better than those after a placebo procedure.

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U2 - 10.1056/NEJMoa013259

DO - 10.1056/NEJMoa013259

M3 - Article

VL - 347

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EP - 88

JO - New England Journal of Medicine

T2 - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 2

ER -

ID: 3036843