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Many operations more harmful than beneficial, top surgeon warns

5/16/2017

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I saw this article recently in Sydney Morning Herald on line and wanted to share it.

Website source: http://www.smh.com.au/national/health/many-operations-more-harmful-than-beneficial-top-surgeon-warns-20170512-gw3pbc.html

This article quotes a top orthopaetic surgeon who explains that many surgeons are performing operations that are likely to do more harm than good.
About half of orthopaedic surgical procedures have no scientific evidence from randomised trials proving they work better than non-operative treatment, Ian Harris told a meeting of 1900 surgeons this week.

Research showed another 25 per cent are no better than non-surgical alternatives. Yet many of these are still being performed.
Among the list of ineffective and potentially harmful operations are: knee arthroscopy for arthritis, some forms of spinal surgery for low back pain, Achilles tendon repairs, some shoulder arthroscopic procedures, and wrist and ankle fracture fixations.

Despite many studies showing knee arthroscopy was not beneficial for almost all patients with arthritis, many medical guidelines continue to support the procedure for such people.

Some surgeons also continued to perform spinal fusion surgery to treat low back pain despite studies showing no benefit over non-surgical alternatives.

A 2012 study of people who had the procedure for low back pain through workers' compensation schemes in NSW found only 3 per cent had returned to pre-injury work duties two years after the surgery. About 70 per cent were still taking strong opioids such as OxyContin in an attempt to manage their pain.

His warning comes amid mounting evidence of ineffective, wasteful and harmful medical treatments worldwide, and not just in surgery. In January, an international group of leading doctors and academics said up to one-third of medical interventions were now being done unnecessarily, causing physical, psychological and financial harm that could threaten the viability of healthcare systems.

The Australian government is reviewing the Medicare Benefits Schedule to eliminate ineffective medical services taxpayers should not be paying for, so it can fund more effective care.
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Bruce Robinson, an endocrinologist who is leading the review, said he was preparing to release new recommendations about changes for spinal surgery and orthopaedics in coming weeks. He estimated the government would start acting on these recommendations at the end of 2018.
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