Countless Americans are told by their physicians and surgeons every year that they need knee surgery. Not only is the surgery extremely expensive but also it is also excruciatingly painful. Patients face much trauma to their leg/knee area when they try to walk on an artificial knee after surgery. The recovery process includes weeks of grueling physical therapy. But a new study shows that all of this might be in vain. Many people may not actually need knee surgery at all.
Numerous orthopedic surgeons suggest that their patients get knee surgery. However, is this actually the right step for you? Knee surgery has various consequences that sometimes outweigh any benefits it may purport to have depending on the patient.
How was the study conducted? CNN explains,
“The study authors analyzed 175 cases, looking at imaging tests to find the degree of arthritis, as well as each patient’s age and reported pain level. Only 44% of the operations were rated ‘appropriate’. Thirty-four percent were ‘inappropriate’, while 22% were inconclusive. But appropriateness is in the eye of the beholder, says Dr. Katz, an orthopedic surgeon at Brigham and Women’s Hospital in Boston. When the current criteria were developed in the late 1990s, knee replacement ‘was considered a treatment of last resort’, Katz writes in an editorial published alongside the study in the Journal of Arthritis and Rheumatism. Today, many are being done in relatively healthy people in their 50s and 60s.”
As Dr. Katz says, the main issue today and the reason experts conducted this study was because knee surgery is being done in fairly healthy people, who do not truly need it. Why is this a problem? Knee surgery costs thousands of dollars. Perhaps your insurance company will cover that. But what about all of the pain and suffering you have to go through due to the surgery? As well as the permanent change in lifestyle?
Many patients are unaware of the fact that after knee surgery they often will not be able to run, sit, stretch, do yoga etc. as they used to prior to the procedure. Plus, after the knee surgery they usually face a tremendous amount of pain and suffering to the point where some patients are on painkiller medications for at least a month following the surgery.
Dr. Riddle, the lead author of the study (and a professor of orthopedic surgery at VCU), told CNN,
“Whether knee replacement should be used to preserve function and not just restore it is worthy of debate. Some patients play nine holes of golf and they want to play 18, and knee replacement can help with that. He says the real question is whether it’s worth the cost – which typically runs between $20,000 and $40,000 – and the potential risks. A knee replacement is major surgery; potential dangers include infection, deep vein thrombosis and pulmonary embolism. There’s even a non-negligible chance of death, although it’s less than 0.5%, according to the paper. With younger patients, other factors come into play. On the other hand, anyone getting a knee replacement in their 50s or 60s has a good chance of experiencing a re-run: approximately 10% wear out within 15 years and need to be replaced again.”
“More than one-third of total knee replacements performed in the U.S. were deemed inappropriate in a new study that used a patient classification system to weigh the risks and benefits. The patients were enrolled in the Osteoarthritis Initiative -- a 5-year study funded in part by the National Institutes of Health. The average age of knee replacement patients in the group was 67 years old, and 60 percent of the patients were women. The study looked at how patients scored on measures of pain and physical function; knee motion and laxity; radiography; and the patient's age. The study found that only 44 percent of surgeries were classified as appropriate, meaning the expected benefits outweighed the likely risks for that patient.”
The study’s authors issued a statement saying that the number of knee surgeries that were deemed inappropriate in the last decade was actually even higher than they had anticipated it would be. Why has the number of knee surgeries risen so drastically? Many experts are arguing that the number of knee surgeries performed every year has sharply risen due to the fact that whether a person actually needs the surgery is based on subjective reasoning and many orthopedic surgeons are taking advantage of this. CBS quoted Dr. Katz as saying, “We should be concerned about offering total knee replacements to subjects who endorse 'none' or 'mild' on all items of the WOMAC pain and function scales.”
Fox news quoted Dr. Riddle as saying, “We found that some patients undergo total knee replacement when they have very low grade symptoms or minor knee arthritis.”
Fox reports, “Based on prior studies, the researchers expected to find that about 20 percent of surgeries were inappropriate. Do these results mean U.S. surgeons are performing too many knee replacements on patients who don’t need them? The authors say that research should now focus on developing a system to separate inappropriate from appropriate knee replacements that is based around U.S. patients.”
Dr. Riddle goes into detail about what patients can do to be their own best advocates. He even provided a plan and way by which patients can do their own screening process to figure out whether they truly need knee surgery.
He said, “I would encourage patients to gather and share information with their family physician and surgeon to determine if they are good candidates for the procedure. The key issues, in addition to a reasonably healthy medical status, are the extent of pain, extent of compromised function and extent of knee osteoarthritis. We have very good prognostic data now and we know that persons with high levels of psychological distress, minor knee osteoarthritis, serious (other health conditions) and multiple joint arthritic disease are at greatest risk of poor outcome.” Following a plan of getting a second opinion and looking into other options first would be highly beneficial to anyone considering knee surgery.
Watch the video below to learn about a fascinating knee replacement surgery case I handled...