According to a study, typical bone and joint procedures may be no more beneficial than physical therapy or medication treatment.

It discovered that the benefits of several of the most common surgeries, such as hip replacements and knee repairs, were not supported by high-quality outcomes.

The University of Bristol sought research that evaluated the clinical effectiveness of ten operations verses non-operative treatments like physiotherapy and medication.

They discovered some evidence from randomized controlled trials that carpal tunnel decompression surgery and total knee replacement are sometimes more beneficial than non-operative therapy.

However in other trials published in the British Medical Journal they found there to be no benefit of having surgery over non-operative therapy, with shoulder rotator cuff repair and lumbar spine decompression.

While national guidelines approve seven of the procedures, it says that the majority of them lack a high-quality body of evidence to ‘definitively’ support them.

Official estimates show that almost one million patients get surgery for musculoskeletal disorders each year.

The absence of evidence does not imply that the therapies are unsuccessful, but it does make determining the “real treatment effect” more challenging.

Professor Ashley Blom, an orthopedic surgeon who led the study, said: ‘There is an urgent need to prioritize research.’ It’s troubling that the majority of routinely used and recommended orthopedic procedures have a limited and low-quality database for their effectiveness.’

‘Interventions may work even if the evidence base hasn’t been created yet, or the observational data is so overwhelming that trials would be regarded unethical or unnecessary,’ he noted. Hip replacement surgery is one example.’

‘There should be no place in the NHS for operations that don’t succeed,’ said Dr. Benjamin Ellis of the charity Versus Arthritis.

‘However, data from the National Joint Registry, which includes millions of people, has proved the benefits of hip and knee replacement surgery.’

‘This study has taken a narrow perspective of the data available for orthopedic surgeries,’ said Bob Handley, president of the British Orthopaedic Association.

‘Total hip replacement, for instance, is one of the most successful and cost-effective operations of all time, not only in orthopedics.’

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