Bob,this is a summary for patients and in his textbook, he includes chapters from surgeons who are doing the surgeries.

However, despite clearly knowing about the procedures-- he has webnars all the time about them-- due to the lack of strong evidence to support them, Stanford is not performing them.

Search the literature, there are no large studies with adequate follow up, and zero double blinded randomized clinical trials. 

Surgeons get a free pass from proving efficacy and safety. There have been two excellent studies in the New England journal, double blind, randomized, where patients got sham surgeries for knee arthritis or meniscus tears, neither showed surgery to be of benefit. Yet they're still widely done and paid for.

We all want a cure, and now there's money in it for the surgeons,but zero obligation to prove long term safety or benefit.

Don't doubt for a minute that Rockson is unaware.

Amoc, as Stanley Rockson is very familiar with surgeons who do LE surgery and includes them in his webnars and textbook, but doesn't support the surgery shows me that he has legitimate concerns.

Here is the study in the NEJM, and is is ethical. All studies that involve people have to pass at IRB--and Institutional Review Board, for ethical concerns.

Now, a surgery, is not subject to an IRB. Surgeons can just do them. Back when the LVA wasn't getting reimbursed, as it was considered experimental, Dr. Chang told me it wasn't a cure. Now that it's getting paid for, that seems to have changed.

http://www.ncbi.nlm.nih.gov/pubmed/24369076

Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear.

Sihvonen R¹, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Järvinen TL; Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group.

Collaborators (9)

Author information

Abstract

BACKGROUND:

Arthroscopic partial meniscectomy is one of the most common orthopedic procedures, yet rigorous evidence of its efficacy is lacking.

METHODS:

We conducted a multicenter, randomized, double-blind, sham-controlled trial in 146 patients 35 to 65 years of age who had knee symptoms consistent with a degenerative medial meniscus tear and no knee osteoarthritis. Patients were randomly assigned to arthroscopic partial meniscectomy or sham surgery.
The primary outcomes were changes in the Lysholm and Western Ontario
Meniscal Evaluation Tool (WOMET) scores (each ranging from 0 to 100,
with lower scores indicating more severe symptoms) and in knee pain
after exercise (rated on a scale from 0 to 10, with 0 denoting no pain)
at 12 months after the procedure.

RESULTS:

In the
intention-to-treat analysis, there were no significant between-group
differences in the change from baseline to 12 months in any primary
outcome. The mean changes (improvements) in the primary outcome measures
were as follows: Lysholm score, 21.7 points in the partial-meniscectomy
group as compared with 23.3 points in the sham-surgery
group (between-group difference, -1.6 points; 95% confidence interval
[CI], -7.2 to 4.0); WOMET score, 24.6 and 27.1 points, respectively
(between-group difference, -2.5 points; 95% CI, -9.2 to 4.1); and score
for knee pain after exercise, 3.1 and 3.3 points, respectively
(between-group difference, -0.1; 95% CI, -0.9 to 0.7). There were no
significant differences between groups in the number of patients who
required subsequent knee surgery (two in the partial-meniscectomy group and five in the sham-surgery group) or serious adverse events (one and zero, respectively).

CONCLUSIONS:

In this trial involving patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after arthroscopic partial meniscectomy were no better than those after a sham surgical procedure. (Funded by the Sigrid Juselius Foundation and others; ClinicalTrials.gov number, NCT00549172.

And the Study that Binney posted: 

Eur J Vasc Endovasc Surg. 2013 May;45(5):516-20. doi: 10.1016/j.ejvs.2012.11.026. Epub 2013 Jan 8.

Complications of autologous lymph-node transplantation for limb lymphoedema.

Vignes S¹, Blanchard M, Yannoutsos A, Arrault M.

Author information

Abstract

OBJECTIVE:

This study aims to assess potential complications of autologous lymph-node transplantation (ALNT) to treat limb lymphoedema.

DESIGN:

Prospective, observational study.

METHOD:

All
limb-lymphoedema patients, followed up in a single lymphology
department, who decided to undergo ALNT (January 2004-June 2012)
independently of our medical team, were included.

RESULTS:

Among
the 26 patients (22 females, four males) included, 14 had secondary
upper-limb lymphoedema after breast-cancer treatment and seven had
secondary and five primary lower-limb lymphoedema. Median (interquartile
range, IQR) ages at primary lower-limb lymphoedema and secondary
lymphoedema onset were 18.5 (13-30) and 47.4 (35-58) years,
respectively. Median body mass index (BMI) was 25.9 (22.9-29.3) kg m⁻².
For all patients, median pre-surgery
lymphoedema duration was 37 (24-90) months. Thirty-four ALNs were
transplanted into the 26 patients, combined with liposuction in four
lower-limb-lymphoedema patients. Ten (38%) patients developed 15
complications: six, chronic lymphoedema (four upper limb, two lower
limb), defined as ≥2-cm difference versus the contralateral side, in the
limb on the donor lymph-node-site territory, persisting for a median of
40 months post-ALNT; four, post-surgical lymphocoeles; one testicular hydrocoele requiring surgery; and four with persistent donor-site pain. Median (IQR) pre- and post-surgical
lymphoedema volumes, calculated using the formula for a truncated cone,
were, respectively, 1023 (633-1375) ml (median: 3 (1-6) months) and
1058 (666-1506) ml (median: 40 (14-72) months; P = 0.73).

CONCLUSION:

ALNT
may engender severe, chronic complications, particularly persistent
iatrogenic lymphoedema. Further investigations are required to evaluate
and clearly determine its indications.

You know what I consider unethical? Promoting a surgery as curative or beneficial when neither are proven.