How Much of Elective Modern Orthopedic Surgery Makes Us Worse and Not Better?
POSTED ON 1/30/2018 IN Research BY Christopher Centeno
This weekend I was at a meeting where I met a colleague about my age whom I saw limping. He was heavier, stooped over, and looked physically beat up. I've known this person for many years, and I know that he has had a number of back and knee surgical procedures. This literally could have been me, as I've had a number of knee and back blowups through the years that we've managed with platelet and stem cell-based procedures. Let's explore this a bit further.
Much of Elective Orthopedic Surgery Doesn't Work
Mounds of research have made it quite clear that so much of elective orthopedic surgery just doesn't work. In fact, the scientific evidence is “scandalously poor,” according to the British Journal of Medicine, with high-level research supporting only 20% of orthopedic surgeries being done.
What are the findings of the other 80%? A lot of ineffective and unnecessary surgeries… Those who had meniscus surgery, one study found, fared no better than those who had a sham surgery. Another study found that meniscus surgery worsened arthritis and increased the likelihood of needing a knee replacement later. Even more disturbing, a study a few years prior found that within one year after meniscus surgery, 81% of patients developed arthritis.
Moving to the shoulder, much of the research also hasn't been supportive for rotator cuff surgery, finding that PT was just as effective at addressing function as rotator cuff surgery. Another showed that over 80% suffered retears following a rotator cuff surgery for a large tear. And as for professional-level athletes who rely on their shoulder for play (e.g., baseball, basketball, etc.)—50% who have rotator cuff surgery never return to the same playing level.
What about the spine? If you're considering a laminectomy or discectomy for a herniated disc or some other disc issue, this one doesn't look good either, with research showing that while you may experience some short-term relief, most of this relief has dissipated by one year post disc surgery. And with a disc replacement comes potential side effects such particles wearing off the synthetic disc and problems with adjoining segments.
Taking spine surgery to a more extreme level, low-back fusion has been found to be no better for function and pain than just participating in physical therapy. In addition, fusion leads to adjacent segment disease (ASD), increasing the risk for more fusions in the future. This isn't an exhaustive list, but you get the idea - orthopedic surgery for pain is just not a successful plan...
My Friend's Bad Choices
So now that you know meniscus surgery (and many other orthopedic surgeries) doesn't work and that it probably causes more and not less arthritis over time, you can see why I believe that my friend was a limping testament to the harmful effects of modern, elective orthopedic surgery for pain.
He began his surgery odyssey with multiple meniscus procedures for meniscus tears sustained while playing racket ball. Since he was middle-aged at the time and research shows that meniscus tears are also common in patients of that age without pain, who knows if any of these tears seen on MRI were even causing his pain? He then ended up with one knee replacement and now needs a second.
I, too, have had multiple knee blowups. One was caused by sitting too long at a conference, and I literally limped around the clinic for weeks. I, too, had a meniscus tear on MRI and could have gotten surgery, but instead, I was cured by a simple trigger-point dry-needling session on my quadriceps trigger points. Since then I've had a few injuries and blowups, all treated with platelet-rich plasma precise injections. Hence, I've never had any surgery. I don't limp and can hike 4 miles and 1,000 vertical feet without issues.
My friend's low back has also been a constant problem. He began with steroid epidurals and ended up with a laminectomy/discectomy. This procedure weakened his low back disc, which is still an issue, which is why he walks bent over. All of this inactivity has caused him to gain 50 pounds, which then makes all of this worse.
My back has had several blowups bigger than my friend's. A few of those happened with lifting from the floor, and all were epic and left me nonfunctional. I had one steroid epidural but then switched to using platelet lysate (the growth factors isolated from my blood platelets). I've had ligament and facet injections and have worked hard for the last year to get my core strong with a trainer. I have disc bulges but have never gotten surgery. I can lift weights, run up the stairs, and work out without pain.
Why Modern Orthopedic Surgery for Pain Is Mostly a Failed Idea
Pain is a function of problems with structure, nerves, and the local chemical environment. Modern orthopedic surgery is focused on fixing structure and ignores the other two. In addition, it often lacks a way to fix structure (even though many patients believe that's what's happening) and instead focuses on cutting out broken pieces of tissue. This leads to more joint degeneration and what you see with my friend.
The upshot? Please don't become like my friend just because your insurance covers the surgery and some surgeon sold it to you. Most elective orthopedic surgery for pain is a bad idea. I'm a living testimony that most of it simply isn't necessary. Please find a Regenexx provider to see if you can avoid going under the knife.
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