New medical advice suggests arthroscopic knee surgery for osteoarthritis is ‘low-value’ and can be harmful for some patients.

The advice is one of five recommendations released today by the Australian Rheumatology Association (ARA), one of the Royal Australasian College of Physicians (RACP) specialty societies as part of the Evolve initiative.

Discussing the recommendations, Professor Rachelle Buchbinder from the ARA said:

“Arthroscopy is used to treat osteoarthritis of the knee and can involve washing out the joint or cleaning up the lining,” Professor Buchbinder said.

“The research shows that arthroscopic surgery for knee osteoarthritis does not seem to affect a patient’s outcome and in some cases, the procedure can actually do more harm than good.

“Doctors and their patients should be considering the benefits and risks of this procedure and discussing alternatives before performing this surgery, especially for those over the age of 50 as health insurer statistics suggest approximately half of these procedures are for this age group.

“We hope these latest recommendations will help doctors and patients avoid unnecessary and potentially harmful tests and rheumatology procedures.”

Despite the lack of scientific evidence that the procedure works, approximately 43,000 Medicare Benefit Scheme funded arthroscopic knee surgeries were performed in the 2016-2017 financial year, costing around $22 million in Medicare benefit payments.

Ms Leanne Wells, CEO of Consumer Health Forum of Australia, said:

“Patients depend on their doctors to recommend treatments that are evidence-based. “These days it is all about value-based care. We want the system and patients to be paying for treatments that get the best outcome for people.

“We don’t want to see arrangements where procedures continue to be performed for years despite a dearth of evidence of their benefit. That’s why CHF welcomed the MBS Review and participates in profession-led initiatives such as Evolve and Choosing Wisely to support the development of more patient-focused information and resources to help informed decisions about treatment.”

To help patients make informed decisions about their treatments, Choosing Wisely Australia has developed ‘5 Questions to Ask your Doctor.'

The Evolve initiative highlights a specialty group’s ‘top five’ clinical practices that may be overused, provide little or no medical benefit or cause unnecessary harm.

Read the full list of recommendations from the ARA at https://evolve.edu.au/published-lists/australian-rheumatology-association/.

There are now 19 Evolve lists published, with further ‘top five’ lists in development.​ For more information go to: https://evolve.edu.au.