Letter to the Editor: Editor’s Spotlight/Take 5: Has Arthroscopic Meniscectomy Use Changed in Response to the Evidence? A Large-database Study from Spain

Reply to the Letter to the Editor: Editor’s Spotlight/Take 5: Has Arthroscopic Meniscectomy Use Changed in Response to the Evidence? A Large-database Study from Spain

“…As you point out [4], my views on the topic of the inappropriateness of arthroscopic meniscectomy in these clinical settings are widely available [10-14], so I will try to keep this brief, but I did feel some response was called for out of respect to you for writing such a thoughtful letter.…”

“…You mention that these decisions tend to get made when “patients no longer have ‘good’ treatment options” [4]. I would maintain that if we find ourselves in the office with someone who is out of “good” options, it’s our responsibility to patients and to our professional integrity to be candid with patients about what options remain.…”

“…

Dear Dr. Brown and colleagues, Thank you for taking the time to write in. Post-publication dialogue is important, and I'm grateful to you for engaging with me on this one.As you point out [4], my views on the topic of the inappropriateness of arthroscopic meniscectomy in these clinical settings are widely available [10][11][12][13][14], so I will try to keep this brief, but I did feel some response was called

…”

“…The fact that patients may grade us through surveys is immaterial. And, according to the American Medical Association (AMA), using that as a justification to recommend an operation that you acknowledge is based on the "hope for a placebo effect that may satisfy patients" [4] is unethical, unless we explicitly tell patients that we are using a placebo as a clinical treatment [2]. Finally, the idea that surgeons might perform surgery for this purpose-with all its attendant risks, costs, and potential harms-strikes me as especially problematic.…”