184 – The Meniscus: when in doubt, leave it in

Meniscectomies were once a very common surgery for knee pain.

Then the data happened.

Teppo Järvinen from the Finnish Centre for Evidence-Based Orthopaedics (FICEBO) joins Chris to talk about the recent 10-year data from the FIDELITY trial, showing that removing the meniscus in patients with knee pain did not improve symptoms and for a broader discussion about the role and importance of sham surgery and placebo controls in surgical research.

He also shows Chris that orthopaedic surgeons are a surprisingly thoughtful and introspective group.

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Editor: Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J.

Przybos Chris’ book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer Obviously, Chris is not your doctor (probably).

This podcast is not medical advice for you; it is what we call information.

References: The FICEBO website: www.ficebo.com The original FIDELITY trial showing meniscectomy had no benefit: https://www.nejm.org/doi/full/10.1056/NEJMoa1305189 The recent 10-year follow-up data from FIDELITY: https://www.nejm.org/doi/full/10.1056/NEJMc2516079 The SIMPLICITY HTN-3 sham surgery trial on renal denervation: https://www.nejm.org/doi/full/10.1056/NEJMoa1402670 Max Planck’s Principle: https://en.wikipedia.org/wiki/Planck%27s_principle