‘Sham’ Surgery Is As Effective as Knee Arthroscopy Procedure for Pain and Function

A "sham" surgery or fake surgical intervention can effectively help one despite the lack of an actual procedure.

Sham Surgery Effective in Helping With Knee Pain

Jeremy Howick, a Professor and Director of the Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, recounted tearing the meniscus in his knee a decade ago. He was limping all the time, and the doctor suggested that he get arthroscopic knee surgery.

Since he was scared of scalpels, he asked for other options. The doctor suggested to try physiotherapy but warned that it was unlikely to work.

Howick tried physio and followed the recommended exercises diligently. It worked for him because his knee pain and function returned to "almost normal." He was even able to run his first and only marathon that year.

He noted, however, that physio was not the only option.

Dr. Bruce Moseley found 180 patients who struggled to get out of their chairs due to excruciating knee pain in the 1990s. After that, they had a real or fake (placebo) arthroscopy.

In the accurate arthroscopy, medications were administered, and a tiny metal tube called an arthroscope was inserted into the knee to replace torn cartilage and remove painfully loose bone pieces.

Painkillers and a minor incision on their knees were part of the "sham" surgery or (placebo) arthroscopy operation. Still, there was no arthroscope, cartilage damage repair, or removal of loose bone fragments.

"Blinding" refers to patients undergoing the phony surgery believing they were getting the real one. Additionally, the nurses and physicians imitated the noises of the actual operation.

Blinding is crucial in ensuring that patient expectations do not affect the outcome.

For two years, all patients were observed to determine the maximum number of stairs they could ascend before experiencing discomfort. The outcome was unmistakable—the fictitious surgery improved both pain and function.

Furthermore, the fake procedure is less hazardous because it is less intrusive. For instance, the chance of infection is decreased.

Moseley's results have been repeated numerous times.

What Is Knee Arthroscopy?

Knee arthroscopy is a type of surgery that examines the knee with a tiny camera. Your knee will be lightly incised to accommodate the small surgical instruments and camera used for the operation.

The procedure is recommended for torn meniscus, torn or damaged anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), swollen or damaged joint lining, misaligned kneecap, broken cartilage in the knee joint, removal of baker cyst, repair or reconstruction of cartilage defects, and fractures of the knee bones.

During the surgery, a cuff-like device can be placed around your leg to reduce bleeding. The surgeon will make two or three small incisions in the knee. The knee will then be inflated by pumping fluid (saline).

One of the incisions will introduce a thin tube with a tiny camera on the end. The camera, connected to a visual monitor, allows the surgeon to see into the knee.

The surgeon might insert additional tiny surgical instruments through the other incisions on the knee. The surgeon will subsequently treat or remove the knee problem.

After the procedure, saline will drain from the knee. The incisions will be dressed once the surgeon sews them shut with sutures.

Many surgeons use the video monitor to snap images of the process. After the procedure, one might be able to examine these images to see the results.

Check out more news and information on MEDICINE & HEALTH in Science Times.