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Arthroscopic knee surgery is one of the most commonly performed surgeries — although research tells us it’s not nearly as effective as most people would like to believe. Additionally, science tells us that people who undergo arthroscopic knee surgery are more likely to have knee arthritis, which progresses more quickly—leading to a total knee replacement, which conceivably could have been avoided.
Arthroscopic knee surgery is a minimally invasive procedure commonly performed to “clean” your knee joint if you have degenerative arthritis or to excise portions of a torn meniscus that could be irritating your knee.
Sounds pretty easy and harmless – right?
Well… it is, until it isn’t. The big problem is that arthroscopic knee surgery is not necessary for most cases of knee pain. If there’s a complication — which are many even with “minimally invasive” procedures — you could end up worse off than when you went in. Also – if you didn’t need the surgery at all – you’re simply sticking your knee through unnecessary trauma that you now need to heal from. This further keeps you from tackling the root cause of your knee pain.
The truth is that most people can get complete relief from their knee pain as well as full recovery of knee function without any type of surgery or procedure. This applies to 70% of all cases of knee pain.
An early 2002 research study by JB Mosely and colleagues, published in the New England Journal of Medicine, showed that placebo surgery was as effective as actual arthroscopic surgery for advanced knee arthritis. Since then, numerous studies have demonstrated similar results. This means that even if you have a torn meniscus or degenerative arthrosis in the knee, you can recover – naturally and with conservative treatment.
So why, despite all this research, are surgeons still performing arthroscopic knee surgeries more than ever?
In some cases it’s only what the surgeon knows and they haven’t kept up with the research. In other cases, it is due to poor conservative management of knee pain. If you’ve had physical therapy and it hasn’t been effective, people are tricked into believing that physical therapy “didn’t work.” But more often than not, you just haven’t found the right physical therapist – someone who understands how to properly diagnose knee pain and can offer you the tailored approach needed to avoid surgery.
And then there’s the elephant in the room.
It’s very common for knee pain to come from somewhere other than your knee. Knee pain can originate in your ankle, hip, or back. A study has shown that 40% of the time knee pain is caused by your back – even if you don’t have back pain. MRIs add even more confusion. It’s entirely possible to have degenerative changes, a meniscus tear, or advanced arthritis in your knee—and your knee pain still has a source other than your knee.
Over the course of my 20-year career, I’ve seen many knee surgeries go wrong. Most of the time it has nothing to do with the procedure itself, but everything to do with an incorrect diagnosis. If your knee pain can be managed conservatively – and you put it through unnecessary trauma (surgery) – chances are you’ll have more problems afterwards. If you are going to have knee surgery when your knee problem is not even coming from your knee then you will definitely have problems afterwards.
The moral of this story is to be absolutely sure that 1) your knee problem really is a knee problem and 2) you’ve exhausted all (good) conservative therapy options before going under the knife.
Keep in mind that 70% of knee pain cases do not require surgery. Science has proven this. Don’t get knee surgery unless you’re 100% sure you really need it. Because things can go wrong and when it does – it’s a lot harder to come back from when you avoided it in the first place.
dr Carrie Jose, Physical Therapist and Pilates Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for the Seacoast Media Group. To get in touch with her or to register for her upcoming Master Class for Patients with Knee Pain, visit www.cjphysicaltherapy.com or call 603-605-0402.
