How useful is arthroscopic surgery?

A study soon to be published in the New England Journal of Medicine has found that arthroscopic knee surgery for a torn meniscus or osteoarthritis produced results little better than physiotherapy and exercise. On a hundred-point functioning and pain scale those who had surgery had an average of 20.9 points of improvement and those who did physiotherapy and exercise, 18.5. The results were more or less the same at 6 months as at 12 months. An earlier study comparing surgery with exercise alone showed similar results for patellofemoral syndrome (pain in the front of the knee) and another done in 2002 comparing arthroscopic surgery versus sham surgery for osteoarthritis of the knee found that

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.

In my own little study two participants, one with chronic patellofemoral syndrome and another with chronic severe knee pain, have found significant improvements both in pain relief and functioning immediately after the first session, and experienced further improvements in subsequent sessions, both well beyond the 18.5 or 20.9 per cent improvement posited by the NEJM study for surgery and physiotherapy with exercise.

Update April 10th: One participant who had been told by a doctor that she was looking at a knee replacement "down the line" reported zero pain and full functioning after her last (fourth out of four) bioenergy treatment. The other participant, who had been diagnosed with chronic patellofemoral syndrome, reported full functioning and zero pain after her third treatment. I will now do regular follow-up to monitor their condition.