Bout of the corner men and not the boxers? Contextual effects flex their muscles
Increased use of MRI in the quest to explain symptoms, and patients’ hope for a ‘quick-fix’, often challenge healthcare professionals in their choice of treatment for the painful ageing knee. In the USA, there are about one million knee arthroscopies per year and the majority involve removal of torn meniscal tissue in middle-aged patients. The absolute number of arthroscopic partial meniscectomies (APMs) in Europe is unknown but may be even greater due to the larger European population. The popularity of this procedure is understandable — multiple case series and randomised controlled trials (RCTs), not to mention doctors’ personal observations of patients, show sustained improvement after APM. However, the last few years, the efficacy of the actual therapeutic element, resection of meniscal tissue, has been called into question.
A hallmark RCT is the exquisitely designed, randomised, double-blinded, sham-surgery-controlled Finnish Degenerative Meniscal Lesion Study (FIDELITY).
Publisher URL: http://ard.bmj.com/cgi/content/short/77/2/159
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