PT may be better than meniscus surgery
By Pam Belluck, New York Times
A popular surgical procedure worked no better than fake operations in helping people with one type of common knee problem, suggesting that thousands of people may be undergoing unnecessary surgery, a new study in the New England Journal of Medicine reports.
The unusual study involved people with a torn meniscus, crescent-shaped cartilage that helps cushion and stabilize knees. Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the United States, performed, the study said, about 700,000 times a year at an estimated cost of $4 billion.
The study, conducted in Finland, involved a small subset of meniscal tears. But experts, including some orthopedic surgeons, said the study added to other recent research suggesting that meniscal surgery should be aimed at a narrower group of patients; that for many, options like physical therapy may be as good.
The best summary for this article is “different strokes for different folks”. And always participate in medical decision making.
I was a serious runner for almost thirty years with zero knee problems. And then, in my geriatricity, I dislocated my knee working around the house. My doctor took one look at me, decided I wasn’t young enough or active enough to deserve much attention, and sent me home.
Getting back to running, I started having progressively worse knee pain.Finally, going to another doctor, it was discovered that not only was my knee pretty much permanently dislocated, my meniscus was becoming trash. Approaching 70 at the time, I insisted that I needed to do whatever could be done to get back to running.
After much discussion and soul searching, my doctor suggested “Micro Fracture Surgery,” a technique invented by former Lake Tahoe orthopod, Dr.Steadman. Researching the suggestion, most of the testing seemed to involve patients under 45.
Nevertheless, I had the surgery. I’d strongly recommend it to anyone, regardless of age, who really wants to return to physical activity. Recovery seems to take forever, with zero weight on the knee for almost two months, and close to a year of self-directed therapy.
But the following year I won medals in the over 70 divisions of two 10Ks – an, admittedly, not especially competitive division.
I’m no longer running, having finally recognized that repairing a knee is not exactly restoring youthfulness. But, at 72, I walk as far as I want and have no knee pain under any circumstances. It was a long recovery, but, fortunately, life is usually even longer and there’s never, ever, a reason to surrender. At worst, you simply drive your kids crazy – remember years ago when they drove you even crazier?