Recent research is showing that might not be needed as often as we think. A large review estimates that 10% to 20% of surgeries might be unnecessary and that in some specialties such as cardiology and orthopedics, that number might be higher. The reasons for so many unneeded surgeries being performed are varied, but the most common is that more conservative options aren’t tried first, or lack of knowledge by the operating physician.
Physicians undergo long and rigorous training programs to become surgeons, but if they don’t work hard to keep learning, their knowledge often stops growing when they leave residency. Recent research is showing that certain common surgeries aren’t any better than (basically a sham treatment). Two such examples are kyphoplasty – a procedure for spinal compression fractures, and – a procedure used to treat tears of the in the (yet, we still see these done all the time!).
If a surgeon hasn’t continued to learn (think of how busy providers get with managing patients not to mention managing home and family life), they won’t know that these surgeries often don’t offer any more benefit than a non-surgical treatment and will continue to perform them. Although not ethically legal, we need to also be aware that every performed can also have a benefit to the pocketbook of the surgeon or company, so some surgeons may be incentivized to fill their schedule just as some providers are incentivized to carry on a lengthened treatment program for monetary benefit (we will talk about how to identify an ethical provider in future blogs!).
Every can be avoided, it should be., even “minor” ones carries risks. These include complications from anesthesia, blood clots after , delayed healing of the incision, infection, and unintended damage to nerves or other organs near the surgical site. Some of these risks cause discomfort for a period after and go away, but others can result in permanent disability or even death. For some patients and conditions, is a great treatment option, but with all the associated risks, when
For musculoskeletal problems like back, joint, and , sprains, and strains seeing your PT before a surgeon can help keep you out of the operating room and get you back to life without . Studies have shown that is just as good if not better than for a multitude of conditions and carries less risk. Some examples would include rotator cuff tears, meniscal tears, spinal stenosis, low back , and .
can’t fix every problem, and for some patients, via is the best choice. However, research is showing that isn’t a cure-all, and is sometimes just a very expensive and risky placebo. In most cases, starting with is the right choice, and for many patients, PT for is the only treatment necessary.
How long is the recovery of a ?
Your doctor may recommend as part of your recovery. It’ll help increase your range of motion and help your get stronger. They may also share some exercises you can do at home. You may have to wear a brace or cast to keep your stable. You’ll likely also have to use crutches for at least a month to keep weight off your . If you have a partial or , you can expect your recovery to take about a month. If your was repaired, it may take as long as 3 months.
is often part of what doctors call “conservative treatment” to avoid , at least early on. People who are middle-aged or have often have a simply because it’s worn down. For them, may be as effective as .
An article in The New England Journal of Medicine studied this. The article, “ versus for a ” wrote that “ is one of the most common orthopedic procedures, yet rigorous evidence of its efficacy is lacking.” It concluded that “In this trial involving patients without but with symptoms of a , the outcomes after were no better than those after a sham .”
Furthermore, “In conclusion, the results of this randomized, sham-controlled trial show that arthroscopic partial medial meniscectomy provides no significant benefit over a () and no . These results argue against the current practice of performing in patients with a .” in patients with