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Dr., a professor of orthopedic surgery at the University of California, San Francisco, who was not involved in the research. Saam Morshed said, “I think it’s fair for us to hold the mirror to ourselves and examine the effectiveness of some of these operations. . It is important to understand where we lack knowledge about the effectiveness or ineffectiveness of common surgical treatments.”
“It’s also important to understand that the lack of a randomized trial supporting a particular treatment doesn’t mean the treatment isn’t effective,” she said. He said hip surgery is a good example. There may not be a randomized trial of hip surgery, but there is overwhelming observational evidence of its effectiveness compared to nonsurgical treatment.
For other common procedures, the picture may be different. One of the most common sports injury surgeries in the United States, an arthroscopic operation to repair the anterior cruciate ligament, or ACL, in the knee has a success rate of up to 97 percent in some studies. But when the operation was compared with nonsurgical treatments, the review found little difference in pain scores or the need for further surgical or nonsurgical treatment.
Researchers describe a comprehensive review of an operation to repair the rotator cuff, the tendon and muscle group that holds the upper arm bone in the shoulder socket. The review found little or no clinically significant difference in pain, function, quality of life, or patient satisfaction with outcomes when compared with exercise and steroid injections.
Some studies were randomized controlled trials that gave a group of patients actual surgery and a matched group a placebo operation. In two such studies of shoulder impingement surgery, a condition that causes pain in arm lift, there was no difference between surgery and placebo surgery in terms of patient-reported outcomes or side effects.
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