Very few surgical procedures have ever been tested against 'dummy' operations, or even doing nothing at all, usually because of ethical concerns—but without these scientific tests, nobody can be sure if any procedure is safe, effective or necessary, says Prof Andy Carr, an orthopaedic surgeon at Oxford University Hospitals.
Instead, any benefits of surgery could be more in the mind of the patient, a phenomenon known as the placebo effect. And that is even more likely with elective surgery—an operation that is not an emergency but which has been chosen by the patient—where any benefits could be entirely down to the placebo effect.
A few medical trials have shown that the patient reported similar benefits after a proper surgical procedure or a 'sham' operation for elective procedures such as knee surgery for arthritis, spinal cement injections for vertebral fractures, and gastric balloon operations.
"The correct thing is. . .not to continue doing operations where we don't know whether or not there's a strong placebo component or an entire placebo component because that means that tens or hundreds of thousands of patients are having unnecessary operations," he said.