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Placebo effects and surgery for overuse injuries

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  • Placebo effects and surgery for overuse injuries

    Research has shown that arthroscopic debridement operations on the knee
    for osteoarthritis often provide little more than a placebo effect. Many
    patients report symptomatic relief after undergoing arthroscopy of the
    knee but it is not clear how the procedure achieves this result. A
    randomized controlled trial to evaluate the efficacy of arthroscopy for
    osteoarthritis of the knee showed that the outcomes after arthroscopic
    lavage or arthroscopic debridement were no better than those after a
    placebo procedure (Moseley et al, 2002).

    Does anyone know if anyone has done any similar research concerning
    common surgical treatments for overuse injuries? Hutson (1997) has cast
    doubt on the efficacy of many forms of medical treatment for overuse
    injuries (such as splinting a sore wrist rather than resting it); hence
    it would be interesting to know if the outcomes of surgery for carpal
    tunnel syndrome (i.e. decompression of the carpal tunnel) ever reflect a
    placebo effect (especially if this is merely due to rest after the


    David McFarlane
    Ergonomist, WorkCover Authority
    New South Wales, Australia


    1. J. Moseley, K. O'Malley, N. Petersen, T. Menke, B. Brody, D.
    Kuykendall, J. Hollingsworth, C. Ashton and N. Wray, (2002), "A
    Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the
    Knee", New England Journal of Medicine, July 11, 2002, Volume 347:81-88,
    Number 2.

    2. M. Hutson, (1997), "Work-Related Upper Limb Disorders: Recognition
    and Management", (Butterworth-Heinemann; Oxford).

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