Thursday, February 20, 2014

Should You Get Knee Surgery?

Although knee problems can occur at any age, the older we get, the more likely we are to develop stiff, painful knees.  Sometimes this is a result of arthritis and sometimes the pain is a result of an injury.  In either case, we often wonder if the only way we will find relief is to get knee surgery, which is one of the more common medical procedures for people over the age of 60.  Recently, however, researchers have begun to question how effective this surgery actually is at providing lasting relief.

Fake Knee Surgery May Work as Well as The Real Thing

According to a report in the December, 2013 New England Journal of Medicine, researchers discovered that people who had fake arthroscopic surgery for a torn meniscus did as well as those who had the actual surgery.  In this study, which was conducted in Finland, researchers studied 146 patients between the ages of 35 and 65 who had degenerative wear and tear of the meniscus.  The meniscus is a piece of cartilage that serves as a shock absorber between the shinbone and the thighbone.  None of the patients in this study appeared to have arthritis, which indicated that their pain was due solely to an issue with their meniscus.

Half of the patients were given an actual arthroscopic meniscectomy in which a surgeon smoothed out the rough edges of the cartilage.  The other half had a fake surgery in which the doctors made an incision but did not do anything.

After a year, both groups were checked.  There was virtually no difference in the knee pain reported by the two groups!  Two-thirds of the people in both groups said they were happy with the surgery and they would do it again.

This research is significant because approximately 700,000 arthroscopic partial meniscectomies are performed in the United States every year.

How to Postpone Knee Surgery

Some orthopedic doctors are beginning to believe that many people who suffer from knee pain might do just as well if they simply underwent physical therapy to strengthen the muscles that support the knee in order to avoid or postpone surgery.  There is also some evidence that many people could be helped by a change in the type of exercise they do.  For example, experts recommend that patients switch from jogging to swimming or biking as a way to stay in shape, since these low-impact exercises put less stress on the joints.

Patients may also benefit from taking anti-inflammatory medication or getting injections of hyaluronic acid before resorting to surgery.

What to Expect from Knee Replacement Surgery

As a last resort, some patients may eventually need to have knee replacement surgery, but only after they have tried the other options, first.  When nothing else seems to help, knee replacement may be the only alternative left, especially when there is advanced osteoarthritis and the meniscus is completely worn away.

Knee replacement surgery is usually undertaken only when people have reached the point when they can no longer perform even the most common tasks, such as walking a short distance.  In these circumstances, most people experience great relief after the surgery, since they have typically been living with tremendous pain and discomfort.

If you are considering knee replacement surgery, expect to stay in the hospital for three to five days, followed by a stay in a rehabilitation facility for another seven to ten days, and then spending an additional six weeks of physical therapy before your muscle strength is restored.  After surgery and recuperation, you should be able to engage in most normal activities, with the exception of running and jumping.

While this was not mentioned in any of the literature I read on knee replacement surgery, some of the people I have known who had the surgery have also found it difficult to kneel or squat afterwards.  In addition, patients need to know that the replacement parts will not last forever.  They may need to be replaced in fifteen to twenty years.  This is another reason why you will want to wait as long as possible before getting the surgery.  If you have the surgery in your 50's or 60's, you may have to repeat it in your 70's or 80's.  As the materials that are used continue to improve, it is possible that, in the future, new joints may last longer.

The bottom line appears to be that you should avoid getting knee surgery as long as you can by changing your activities, doing strengthening exercises, taking anti-inflammatory medications and getting shots.  Only when these options no longer work for you, should you seriously consider knee replacement surgery.

As always, you will want to discuss your options with your doctor and you may even wish to get a second opinion before deciding on any knee surgery.


If you are interested in reading about other medical concerns as we age, click on the medical issues tab at the top of this page to find links to articles on a variety of topics.  In addition, you may want to check out the other tabs to find articles about where to retire here and abroad, family relationships, financial planning and more.

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1 comment:

  1. I don't know that I'd volunteer for a study where I get an incision without actual surgery but this is incredibly fascinating! Great report!


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