Decades Of Knee Surgery Have Been Misguided


Published:

A team of UB physicians has published a study that challenges a surgical practice used for decades during arthroscopic knee surgery.

When treating meniscal tears -- one of the most common orthopaedic surgical procedures -- surgeons also have clipped and smoothed any dislodged cartilage they found in the belief it was helping patients. But the new study finds that practice does not benefit the patient. Patients who did not have dislodged cartilage removed recovered faster, with less pain, and ended up a year later with identical results.

“Those with less surgery got better faster in comparison with the people we did more surgery on,” says Leslie J. Bisson, professor and chair in the Department of Orthopaedics in the Jacobs School of Medicine and Biomedical Sciences and lead author of the study.

The finding was so surprising that an editor at The Journal of Bone & Joint Surgery, which published the study, also published a commentary:

“The conclusion that unstable cartilage lesions do not need debridement could have a dramatic impact on practice management, save health care dollars, and improve early patient outcomes.”

The American Academy of Orthopaedic Surgeons also distributed the study in its weekly collection of papers of note.

Doctors check for arthritis -- the tearing or dislodgement of articular cartilage called chondral lesions -- using X-rays when they are preparing to treat a meniscus in the knee. But sometimes low-level arthritis is not visible, and doctors find it only when they are inside the knee, Bisson explains. At that point, doctors always have opted to clip and smooth any loose cartilage.

Better Early Outcomes

The study followed 190 patients who were having arthroscopic partial meniscectomies (APM). Of those, 98 received debridement of the damaged cartilage and 92 did not receive debridement. Both groups had the same results one year after surgery, but prior to that, the group without debridement had less pain and better function than those who had the cartilage trimmed and smoothed.

“That was very surprising to us,” Bisson says. “We are bringing those patients back and doing X-rays at five years to see if it made a difference in their arthritis.”

In the meantime, surgeons at UBMD Orthopaedics & Sports Medicine, where Bisson and the other doctors involved in the study practice, are no longer debriding knee cartilage when repairing meniscal tears.

“That’s a marked change. In my group, with five sports medicine doctors, we do close to 1,000 APMs a year,” he says.

Middle Age Injury

A meniscus is a little cartilage cushion on the inside and outside of the knee, and it can break down in middle age, or it can become damaged by trauma as gentle as squatting down to get something out of a cupboard or to line up a putt on the golf course.

“You stand up and you feel something catch in your knee,” Bisson says.

He expects that not everyone will embrace a challenge to the way such injuries have always been treated. “One of the things we say in surgery is you can’t practice based on the last study that was done. Hopefully this will push others to investigate this topic and consider things they are doing on a daily basis,” he says. “We should question everything that we are doing that is not based on evidence.”

This article was republished from Prevent Disease.

See also:
Why ‘Useless’ Surgery Is Still Popular
Balance Your Body To Relieve Pain

Edit Module
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags

Daily Astrology

February 17, 2018

First thing in the morning a tricky angle between Mars and Neptune increases certain risk factors. Inclement weather and poor judgment are among others. Soon after, Mercury’s conjunction with the Sun inspires some to hit the open road. A change of…
Edit ModuleShow Tags

Alternative Health Directory

Browse all listings »

Edit ModuleShow Tags
Edit ModuleShow Tags

Calendar

February 2018

Two Sundays, January 14th and February 11th Learn advanced techniques for self-care, to offer Reiki to others from a distance and for manifesting what you want in your life! Facilitated...

Cost: $250

Where:
Northeast Reiki Center
61 Nicholas Road, Suite B2
Framingham, MA  01701
View map »


Sponsor: Northeast Reiki Center
Telephone: 508-808-5696
Contact Name: Lou Orsan
Website »

More information

Join us the Second Sunday of the month at the Northeast Reiki Center classroom in Framingham for a Reiki Circle in the Usui Reiki System of Natural Healing. We are a gathering of Reiki...

Cost: Free

Where:
Northeast Reiki Center
61 Nicholas Road, Suite B2
Framingham, MA  01701
View map »


Sponsor: Northeast Reiki Center
Telephone: 508-808-5696
Contact Name: Lou Orsan
Website »

More information

Are you curious about yoga but don't know where to begin? The Intro to Yoga Series is a great place to start your practice. This series will provide a safe, non-competitive and welcoming...

Cost: $90 for series

Where:
YogaLife Institute
6 Chestnut St, Suite A
Exeter, NH  03833
View map »


Telephone: 603-969-8968
Website »

More information

Show More...
Show Less...

Qigong and tai chi are 2500+ year old healing arts originating in China. These moving meditations offer unique health benefits that western medicine is...

Cost: $11-$15 per class

Where:
Chelmsford Wellness Center
3 Littleton Road, 2nd Floor
Westford, MA  01886
View map »


Sponsor: Cultivating Qi
Telephone: 978-856-8118
Contact Name: Dave Crocker
Website »

More information

January 8 - February 12, 2018 Intuition + Energy Medicine + Energy Psychology = The REAP Healing Method This 6 week certification training course provides you with the understanding and the...

Cost: $695

Where:
Live Online
Comfort of Your Home
, MA
View map »


Sponsor: The REAP Healing Method
Telephone: 978-877-8651
Contact Name: Pamela Dussault
Website »

More information

A guided tour in discovering, confirming and verifying your personality, behaviors and habits. A three part series at the Waltham Public Library Monday, February 5 7:15PM Monday, February 12...

Cost: Free

Where:
Waltham Public Library
735 Main Street
Waltham, MA  02451
View map »


Sponsor: Waltham Public Library
Telephone: 781-314-3429
Contact Name: Louise Goldstein
Website »

More information

Show More...
Show Less...

Experience the power of singing gospel music with more than 250 others as part of the Mystic Chorale, led by award-winning director and composer, Jonathan Singleton. Join Mystic as we prepare...

Cost: $105

Where:
First Parish Unitarian
630 Mass Ave.
Arlington , MA
View map »


Sponsor: The Mystic Chorale
Telephone: 781-738-1920
Contact Name: Jai Kaur Annamaria
Website »

More information

Show More...
Show Less...

Please join us at our monthly meetings, second Wednesday each month in Northboro, MA. Stay inspired and create collaborative professional relationships. A welcoming community working for the...

Where:
First Parish Unitarian Church Hall
40 Church Street
Northborough, MA  01532
View map »

More information

Show More...
Show Less...

Qigong and tai chi are 2500+ year old healing arts originating in China. These moving meditations offer unique health benefits that western medicine is integrating into treatment plans. By...

Cost: $12-$17 per class

Where:
Dragonfly Wellness Ceneter
176 Jackson Road
Devens, MA  01434
View map »


Sponsor: Cultivating Qi
Telephone: 978-856-8118
Contact Name: Dave Crocker
Website »

More information

Show More...
Show Less...

Led by Deanna Jayne, Authentic Lifestyle Mentor The womb chakra ~ the most sacred place in our physical body, a supreme source of spiritual energy, clarity, and power. When this chakra is...

Cost: $351

Where:
Groton Wellness
495 Main Street
Mill Run Plaza
Groton, MA  01450
View map »


Sponsor: Deanna Jayne
Telephone: 978-449-9919
Contact Name: Amy Ashman
Website »

More information

6 Week Series with Sherri Snyder-Roche Start your year with greater awareness. In Kundalini Yoga, we harness the mental, physical, and nervous energies of the body and put them under the...

Cost: $90

Where:
State of Grace Yoga and Wellness Center
104 East Hartford Ave.
Uxbridge, MA  01569
View map »


Telephone: 508-278-2818
Website »

More information

Show More...
Show Less...

Lauren Rainbow Limited to 16 students! Be sure to register early! This unique one-day course on mediumship, with medium Lauren Rainbow, is focused on developing heart-centered messages from...

Cost: $150

Where:
Circles of Wisdom
90 Main Street
Andover, MA  01810
View map »


Sponsor: Circles of Wisdom
Telephone: 978-474-8010
Contact Name: Cathy Kneeland
Website »

More information

Spend a cozy winter weekend with colleagues diving into the rich material contained within the Dàodéjīng. While each class builds upon the material covered in the previous...

Cost: $325

Where:
Roots and Wings Yoga and Healing Arts
317 North Main Street
Natick, MA  01760
View map »


Sponsor: Eastern Medicinal Therapies Education Center
Telephone: 617-435-3586
Contact Name: Lauren Paap
Website »

More information

Show More...
Show Less...
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags