The past few weeks saw a number of articles and papers come out on the issue of elective orthopedic surgery. When you are being told you “need” surgery for anything that is not life or limb threatening, there’s almost always time to dive in, learn more, seek another opinion or two, and talk to your family and loved ones to explore your options.
This past week saw articles relating to the fact that:
- Many patients with joint replacements do not experience tremendous improvements in their quality of life IF they have multiple joints affected by osteo or rheumatoid arthritis. The results of the surgery on the limb operated on might be great, but the overall improvement was less dramatic because of the disability brought on by the other joints which remain affected.
- During the American Academy of Orthopedic Surgery meeting a scientific paper was released in the New England Journal of Medicine that the results of Physical Therapy for the treatment of meniscus tears AND osteoarthritis (present in the same knee) was similar to the results obtained with surgery.
- A scientific paper presented by the shoulder surgeons at the Hospital for Joint Disease showed that the number of patients being told they “need” surgery for rotator cuff tears rose over a 10 year period. The authors postulated that this was due to the fact that a new billing code (CPT code) was released which enabled docs to bill your insurer for the procedure.
- A number of papers have come out recently showing that many small, degenerative rotator cuff tears do NOT become larger with time and can usually be treated successfully with physical therapy, observation and/or injections.
Bottom line…. For those of you who have been told that you “need”, “must have”, or “should have” surgery for a meniscus tear in the presence of arthritis, a small degenerative rotator cuff tear, or even a joint replacement when many of your joints are affected — be sure to question your surgeon about the latest literature. Don’t be afraid to speak up… many of us welcome the discussion.
That’s what we’re here for — to educate you!
After the skiing accident 2 months ago, I can still hardly walk. I have small joint effusion, moderate sprain on ACL, high grade sprain on MCL grade 2 versus grade 3. There is a tear through the body and posterior horns of medial meniscus. Large bone contusions compatible with pivot shift type traumatic mechanism.
Do I need surgery?
I would truly appreciate your opinion.
Howard J. Luks, MD says
Sorry to learn of your injury. Multi-ligament knee injuries can take quite a while to recover from. I can not tell you whether or not surgery is necessary. The laws in our country and the fact that I haven’t examined you nor discussed the issues with you preclude me from making an informed list of choices, and treatment recommendations.
Find a good sports medicine doctor, well versed in multi-ligament injuries — good luck!