"The surgery was two years ago and the knee never has bothered me since. It's just like my other knee now. I give a whole lot of credit to Dr. Moseley." - Sylvester Colligan
In the Summer of 1994, Sylvester Colligan, a 76-year-old World War II veteran from Beaumont, Tex., underwent Arthroscopic knee surgery to relieve arthritis pain in his knee. Sylvester's surgery was a success and now, years later, he is perfectly healed and walking without any pain whatsoever.
But there is a catch to this story............he never actually had any surgery at all.
He just 'thought' he did.
Osteoarthritis, a degenerative joint disease, is the most common form of arthritis, and commonly occurs in the knee. Symptoms include pain, stiffness, and swelling. Treatment typically involves pain-relieving and anti-inflammatory drugs, along with heat-therapy and exercise. When these fail, surgery is often recommended. In the United States, it is estimated that more than 650,000 arthroscopic debridement or lavage procedures are performed each year, many of these for arthritis, at a cost of about $5,000 each.
A typical arthroscopic knee surgery is a two step process, lavage and debridement. Small incisions are made into the knee that allow a small camera to be inserted and allow the surgeon to see the knee joint itself. Then water is used to flush the knee joint of any debris (lavage). Finally, a scraper is used to smooth down any rough cartilage (debridement). The procedure is fairly non-invasive, and generally successful. But it can be quite expensive, even with insurance. And of course there is always a chance of complications.
Dr Bruce Moseley, an Orthopedic surgeon in Houston, Tx was curious which part of the technique was the most effective, the rinsing, or the scraping. Hoping to refine the procedure, he approached a colleague to help him set up a trial. What he was not counting on was his colleague's response: "You need to also account for The Placebo Effect".
Bruce says, "I almost laughed out loud, as all good surgeons know there is no Placebo Effect in surgery" This is common as most people associate a placebo with a pill. Placebo pills have been effective in treating everything from headaches to depression. This is remarkable all by itself because how can a sugar pill cure depression? Because 1) we don't know it's a sugar pill, and 2) we believe it will work. And it does work. In fact, it is just as effective as popular antidepressants. (but that's another story)
So Dr Moseley designed a trial where 180 patients would be put under the knife for arthroscopic knee surgery. They would be divided up into 3 groups. Group 1 would receive just the flushing. Group 2 would receive just the scraping, and group 3 would receive a placebo. In order for the placebo group to be convinced, it would have to look as if they really did have the surgery. So small incisions were made in the knee and then immediately sewed up, while a video tape was played of a previous, real surgery. No other procedure was done to the placebo patients.
The results:
During two years of follow-up, patients in all three groups reported moderate improvements in pain and ability to function. However, neither of the intervention groups reported less pain or better function than the placebo group. Indeed, the placebo patients reported better outcomes than the debridement patients at certain points during follow-up. Throughout the two years, the patients were unaware of whether they had received real or placebo surgery.
And as you can see in the video, Mr Colligan is walking just fine, 6 years later. And Korean War Vet Tim Perez, who used to need a cane to walk, is now playing basketball with his grandchildren.
In this world, anything is possible if you put your mind to it. I know your mind can work miracles. Tim Perez
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