“Congratulations young lady. You win the prize for the worst knee I’ve seen all week.”
My orthopedist said those very words to me about two years ago after taking a look at an x-ray of my bum knee. I had limped into his office using a cane, barely able to walk. I was in a lot of pain, and very worried.
But I was lucky, my doctor is a “surgery is the last resort” kind of guy. His prescription for the arthritis in my knee was to have me recommit to my lap swimming and start taking a glucosamine and chondroitin supplement.
He assured me that this, along with simply time, would get me back on my feet, and cane free again. He was right.
Oh I still have a bum knee, of course. But the cane is packed away in the back of a closet and I’m mostly back to my old self again. And it cost me nearly nothing. Just some patience and a few bucks for my monthly supplement.
2 million have knee surgery every year
A lot of folks aren’t as lucky as I am, however. Around two million people go under the knife every single year for degenerative knee disease, also known as arthritis. Arthroscopic knee surgery is a three BILLION dollar a year business in the US alone.
Experts estimate that each surgery can cost anywhere from $2,700 to $8,970 (+) a pop, depending on where you live, and the work you need done.
If those surgeries worked… if they were the only way for folks to recover and be pain free… I’d be the first one to say they’re well worth the investment. After all, a good quality of life is priceless.
The trouble is they don’t work. In fact, experts say these so-called “keyhole surgeries” offer very little, if any, benefits at all (more on that in a moment).
Knee surgeries offer little to no benefit
For example, in a meta-analysis published in the British Journal of Sports Medicine, researchers concluded there were small, but inconsequential, benefits from arthroscopic knee surgeries.1 And according to a study published in the British Medical Journal the surgeries aren’t any more effective than simple exercise therapy. 2
Yet most guidelines still recommend going under the knife, and doctors continue to recommend these surgeries in droves. Leading countless folks to face the anesthesia, pain and potential complications of a major surgery, without getting any benefits.
(Don’t be fooled by the whole “key-hole” surgery image, either. As a surgeon once explained to me, the cut on the outside may be smaller, but you’re still getting the same amount of work done inside.)
This is what prompted a panel of international experts to work together to produce a “the buck stops here” comprehensive analysis of all the latest evidence. The panel included clinicians, bone surgeons, physiotherapists and even patients who had arthroscopic surgery as well as folks who had opted not to have it.
Expert panel says no to arthroscopic knee surgery
Their systematic review, published in BMJ Open, found that arthroscopic knee surgery typically does not offer long term pain relief. Even worse, the invasive surgeries don’t improve function in essentially ALL cases.3
In other words they’re a complete and utter failure.
The panel of experts strongly recommends against arthroscopic knee surgery for degenerative knee disease for almost all patients. If your doc is pushing for knee surgery don’t be bullied into going under the knife. Get a second opinion instead.
I’ve been in your shoes, so I get it. Having a surgery is a very personal decision. In some cases it might turn out to be the best decision for you. But you should make it with your eyes wide open, and your wallet under lock and key, until you’ve carefully weighed all of your options.
Wishing you a future of pain free knees.
References:
1. “Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms,” Br J Sports Med2015;49:1229-3
2. “Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up,” BMJ 2016; 354
3. “Application of minimal important differences in degenerative knee disease outcomes: a systematic review and case study to inform,” BMJ Rapid Recommendations, BMJ Open 2017;7:e015587
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