Surgery for Knee Arthritis, Meniscus, Not Needed To Stop Pain, Restore Function
The Fitness Fixer
The Fitness Fixer

Surgery for Knee Arthritis, Meniscus, Not Needed To Stop Pain, Restore Function

Good news. If you don't like or want knee surgery for most arthritis or meniscus injury, you don't have to have it. Lack of need for surgery has been demonstrated over many years in rehabilitation populations, and in a mostly ignored older clinical study. Recent studies confirm you can stop most pain and restore function just as well without surgery through good physical rehab.

Millions of Americans undergo arthroscopic surgery for knee pain every year. Over the last 30 years, arthroscopic surgery has been routinely accepted and prescribed for knee pain without undergoing rigorous evaluation.

Even when a 2002 study published in the New England Journal of Medicine (NEJM) found that results of arthroscopic surgery for knee osteoarthritis were no higher than medicine and physical therapy alone, the surgical community "remained unswayed."

Dr. Brian Feagan, co-author of a study in the Sept. 11 2008 issue of the NEJM stated, "It really didn't change practice that much. That's why this second [study] was really important."

Feagan's randomized, controlled trial involved 178 patients, average age 60. All had moderate-to-severe osteoarthritis of the knee. Half underwent arthroscopic surgery plus medical and physical therapy. The other half used medical and physical therapy alone. After two years, both groups' scores on a measure of arthritis severity were about the same.

A second study also published in the same journal issue, found that meniscal tears are common in the general population and, "may not, in fact, be responsible for painful symptoms." That means that if you have knee pain, and have scans and imaging which show a meniscus tear, it may not even be the tear that is causing the pain.

"There's going to be a swing in practice," said Dr. Feagan.

Study authors stated that meniscal tears detected on MRI may confuse matters and lead to unnecessary therapy. This is a similar finding to back pain where patients with pain are shown to have a herniated disc, stenosis, or other finding, but the pain is not from the anatomical finding, but the same bad movement habits, slouching, and lack of good movement that make anyone hurt. Discs also often appear herniated, and spines compressed by stenosis on scans of people with no back pain. Don't base your treatment and future on a picture. Scans are not tea leaves.

Poor knee stability increases risk of developing arthritis, and increases wear on the meniscus. Studies tracking results for years following surgery are finding that surgery "adds no benefit over rehabilitative training alone." That means you don't need the surgery to fix or prevent possible future arthritis.

You don't have to have surgery to stop knee pain:

How to fix and prevent knee pain from arthritis and most meniscus injury:


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Dr. Bookspan is an award-winning scientist whose goal is to make exercise easier and healthier.