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Arthroscopic lavage and débridement are used frequently to treat patients with knee osteoarthritis whose symptoms are refractory to medication. However, these procedures have not been subjected to rigorously controlled trials; indeed, the 2001 edition of Harrison's Principles of Internal Medicine notes that such procedures have a large placebo effect and that studies with a sham-procedure control group have not yet been reported. Now, we have such a study.
Researchers at the Houston Veterans Affairs Hospital and Baylor College of Medicine randomized 180 patients with knee osteoarthritis and moderate pain (despite maximal medical therapy) to 3 groups: arthroscopic lavage; arthroscopic lavage plus débridement; or a placebo procedure, in which …