Comox Valley Chiropractor – Tips for your Health

Health tips from your Comox Valley Chiropractor

Knee Surgery Ineffective September 14, 2008

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A research study published this week in the New England Journal of Medicine states that Arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy.”

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Researchers followed two groups of patients with knee arthritis randomly assigned to receive either knee surgery or physical therapy plus over the counter medication. A follow up at two years showed no difference in pain level and quality of life between the two groups.

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This study is not the first to demonstrate the ineffectiveness of knee surgery for osteoarthritis. A study in the July 2002 edition of the New England Journal of Medicine demonstrated that the outcome after knee surgery was no different than that of placebo treatment (incisions but no surgery).

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Knee surgery is a common procedure recommended for arthritis sufferers for the simple reason that it has always been done. Now, there is mounting evidence that conservative care is just as effective as the surgery, never mind being less invasive, safer and less of a cost on the health care system.

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It is my opinion that as responsible health care consumers, we must make smart informed choices on treatment options. Practically speaking, for most conditions it is wise to choose the most conservative form of therapy first and save the most invasive (surgery) for later. The worst thing that will happen with most conservative therapies is that you don’t improve. Conversely, the worst consequences for surgery include infection, sepsis and death (especially with all the drug resistant bacteria in hospitals such as c. difficile).

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The effectiveness of many common surgical procedures (including those for low back pain) is starting to be questioned. If you would like to learn more about what your options are for conservative therapy, please contact your Comox Valley Chiropractor.

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3 Responses to “Knee Surgery Ineffective”

  1. Hi Dr. Wright.

    Just to clarify, it is important to note that the study focused only on arthroscopic surgery and only on arthritis-related knee problems. Arthroscopic knee surgery is still considered beneficial in other conditions that affect the knee, such as meniscal and ligament problems. Patients who have a combination of knee problems, such as osteoarthritis plus a meniscal tear might also respond well to arthroscopy.

    Of course, like you, I am more in favor of conservative treatments, especially chiropractic and cold laser therapy, but I did not want you to accidently mislead your readers.

    Regards,

    Brett L. Kinsler, DC
    http://www.rochesterchiro.wordpress.com

  2. drdebbie Says:

    Thanks Dr. Kinsler. Although I attempted to clearly state that fact in the first paragraph (in bold), its always good to be specific about the conditions of the research study. Conclusions can only be drawn with the specific procedures and patient population under scrutiny. Thanks for your comment!

  3. I’d have to say that the whole idea of arthoscopic knee surgery is falling apart. About the same time as the above study, another paper was publsihed showing that 60% of meniscus tears prodiced no pain. We now use an injection of the patient’s own culture expanded, mesenchymal stem cells rather than most surgeries, see http://jointpreservation.wordpress.com/2009/01/06/orthopedic-knee-surgery/


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