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QI have knee arthritis causing ongoing pain. An MRI also showed a torn meniscus cartilage. A doctor is recommending arthroscopic surgery, but I’ve read that doesn’t help with arthritis. Could you provide some advice?

AThree words: Don’t Do It. Studies show, and we know from our own experience, that arthroscopic surgery does nothing to relieve arthritis pain. Not only is this surgery useless; it often makes arthritis worse by causing more inflammation in the joint.

I typically see one or two patients a week after another orthopedic surgeon performed arthroscopic surgery a few months earlier. Patients are very unhappy because they are in worse pain than before they had the procedure. Many were told minimally invasive arthroscopic surgery would buy them time before needing a knee replacement, and they are disappointed

Patients hoping to put off joint replacement may have heard that it’s a painful surgery with a long recovery. However, major advances in technology, surgical technique and pain control have benefited patients. Robotic-assistance and computer navigation have enabled a very accurate surgery using smaller incisions. A long-lasting anesthetic nerve block applied during surgery and an improved pain management protocol after the procedure result in less discomfort. Many times, motivated patients in good general health can go home the same day.

The first line of treatment for people with arthritis should be nonsurgical. This often includes physical therapy, pain medication such as anti-inflammatories, activity modification and possibly a steroid injection.

When conservative treatments fail to provide relief, joint replacement surgery is the only tried-and-true remedy for ongoing, painful arthritis. If the damage is limited to just one area of the knee, we can do a partial joint replacement, which generally leads to a quicker recovery. It’s important to get the proper diagnosis and the right treatment sooner, rather than later.

You may be wondering when arthroscopic knee surgery would be appropriate. It may be recommended if a patient has “mechanical symptoms” that are causing pain and making it difficult to walk. There could be a large cartilage tear or a loose body in the knee – a small fragment of cartilage or bone - that’s getting caught in the joint and preventing normal movement. In these cases, minimally invasive arthroscopic surgery may be indicated to repair the tear or remove a loose body. But it is not recommended for someone with ongoing symptoms from arthritis.

Bottom Line: A second opinion is always a good idea when elective surgery is recommended. For patients with ongoing, painful knee arthritis, arthroscopic surgery usually does more harm than good.