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Should You Have Knee Surgery?

Knee surgery is one of the most common orthopedic surgeries in the U.S., but is it effective?

By
Sanaz Majd, MD,
Episode #203

While practicing medicine in primary care, we doctors get to see our fair share of aches, pains, and injuries. The bigger joints are often a common culprit of agony, with the knee joint being one of the worst. After all, we use our legs every day, and we often take them for granted. But those suffering from chronic knee pain will tell you how their quality of life can be truly diminished.

With that being said, it’s no wonder that knee surgery is one of the most popular orthopedic surgeries of all time. And if you are between the ages of 35 and 65 with knee pain, it's more than likely you have contemplated knee surgery at some point in your life.

Orthopedic knee surgeries have built quite a profitable niche within the medical community. Arthroscopic meniscal tear repairs, the most common knee surgery in the U.S., costs an estimated $4 billion dollars a year alone. This is an operation under anesthesia, making an incision in the knee, inserting a camera to look inside while simultaneously repairing or smoothening out the very common wears and tears on this crescent-shaped piece of cartilage (called a “meniscus”) inside the joint.

Middle-aged patients, who concomitantly suffer from arthritic and age-related changes in the knee causing the wear and tear on the meniscus, comprise the largest group of patients who undergo this operation, and who perhaps should think twice about doing so.

The truth is this: not everyone with knee pain needs knee surgery. In fact, most people don’t.

There was an enlightening study released in the New England Journal of Medicine in 2013 that helped support what doctors, including some orthopedic surgeons, have suspected all along: meniscal tear repairs are just as effective as sham (meaning fake) surgery. They studied 146 patients from age 35 to 65 who were divided blindly (meaning the patients themselves didn’t know which group they belonged to during the entire study) into two groups of patients—one group who did have the true meniscal repair, and another who had an incision (and was led to believe they had the surgery). but no repair was done. Not surprisingly, both groups reported similar improvement after one year.

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