This is a post that some orthopedic surgeons will hate but that needs to be written. This week, I decided to try and estimate the number of orthopedic surgeries that were still being done despite research showing they didn’t work. When I was done, I realized that a staggering 53% of orthopedic surgeries being performed are useless (i.e., they have research that shows that they either don’t work or are unnecessary).
We all believe that our doctor has our best interest at heart, and that’s usually the case. However, in the past decade, the research on orthopedic surgery has been brutal—finding that many common surgeries that patients still get every day actually come under the category of useless orthopedic surgery. Don’t take my word for it; there’s both a recent scientific paper that states this and a recent New York Times article.
To create the above graph, I began with orthopedic procedures that have either been shown to be no better than placebo or conservative care or that have been shown to have no benefit over doing nothing. I then dug into the research to estimate the total number of elective orthopedic procedures and then the annual numbers for each surgery. The above numbers are estimates as some of the data only exists for one recent year or another and some data is years old.
I will go over these based on the number of surgeries per year. The total number of surgeries per year above has been modified by the number likely to apply to the research. So, for example, for low-back fusion, the goal was only to count the number of fusions done for stenosis.
While the above is my best estimate, given the research that’s been mounting for the past several years showing how ineffective many orthopedic surgeries truly are when studied, it’s not surprising. How much longer will insurers pay for these procedures? Your guess is as good as mine.
The upshot? There are lots of ineffective surgeries out there, and the useless orthopedic surgery list is among the longest as I would estimate that about half of all elective orthopedic surgeries being performed have been shown to be ineffective based on the research. Time for a change?
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…