Surgery or no surgery?

For most musculoskeletal (MSK) conditions with sufficient available data for meta-analyses there were no clinically relevant differences between surgical and non-surgical treatment. This suggests that non-surgical treatment is often a useful alternative to surgery. This is the main conclusion of a new systematic review with meta-analysis.

The study deals with the benefits and harms of surgical and non-surgical treatment of MSK conditions, respectively. It compares the two types of treatment in relation to four parameters: Pain and physical function reported by the patients, quality of life (for benefits) and serious adverse events (for harms).

The meta-analyses showed that for 9 out of 13 conditions there was no evidence that surgery had a clinically relevant greater effect compared to the non-surgical treatment on pain. The same was true for 11 out of 11 conditions in relation to physical function and for 9 out of 9 diseases in relation to quality of life. In 13 of 16 studies that included data on serious adverse events, there was no difference between surgical and non-surgical treatment; the same was the case in 16 out of 16 studies with data on death after the two forms of treatment.

Based on the study the researchers behind the study conclude that for the conditions where surgery does not seem to carry a greater effect than non-surgical treatment, , it would be advantageous to start with the non-surgical treatment, which is often both effective for the patient and less expensive for society. At the same time, they emphasize that there is a great need for further research in the area, as the study showed a great lack of high-quality studies in a wide range of conditions.

Read the full paper on the study by clicking on the link below.

Søren T. Skou, Erik Poulsen, Alessio Bricca, Mette Dideriksen, L. Stefan Lohmander, Ewa M. Roos, Carsten B. Juhl. Benefits and Harms of Interventions With Surgery Compared to Interventions Without Surgery for Musculoskeletal Conditions: A Systematic Review With Meta-analysis.

https://www.jospt.org/doi/10.2519/jospt.2022.11075