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When taking a step back is a veritable leap forward. Reversing decades of arthroscopy for managing joint pain: five reasons that could explain declining rates of common arthroscopic surgeries
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  • Published on:
    The orthopedic community does not oppose non-operative treatment of degenerative meniscal lesions
    • Romain Seil, President ESSKA office Centre Médical |
    • Other Contributors:
      • Philippe Beaufils, MD
      • Roland Becker, MD
      • Jacques Menetrey, MD

    “When taking a step back is a veritable leap forward. Reversing decades of arthroscopy for managing joint pain: five reasons that could explain declining rates of common arthroscopic surgeries.” Ardern CL, Paatela T, Mattila V, et al. Br J Sports Med 2020;54:1311-1313.

    We have read your editorial with curiosity. Meniscal preservation is a major challenge for modern orthopaedics (1, 2). And when middle-aged patients have knee pain from degenerative meniscus lesions or incipient osteoarthritis, their first treatment should be non-surgical. We are all agreed about that. It was a clear conclusion from ESSKA’s (European Society of Sports Traumatology, Knee Surgery and Arthroscopy) recent consensus project based on strict and transparent methodology (3).

    Unfortunately, your editorial overlooked our exhaustive analysis and was, at times, more assertive than empirical. It seemed to assume that orthopaedic surgeons and their societies will oppose non-operative treatments, simply because they are surgeons. This animus is unhelpful: it stigmatises our community; it creates mistrust amongst our patients, and it risks more and disruptive regulations. And we have already been here, with combative publications (4,5) inviting combative replies (6,7). It was to avoid these immature polemics that ESSKA intervened.

    We would note that ESSKA’s investigation — and the subsequent Consensus Statement —involved 21 countries (3) and has been disseminated, in their mother tongue...

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    Conflict of Interest:
    None declared.