Five Ways to Avoid Knee Surgery

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Five ways to avoid knee surgery
Study reveals other methods can have good results

A recent study shows that surgery may not be more beneficial than exercise when it comes to dealing with knee pain.

In the study, published in the BMJ, Norwegian researchers followed 140 male patients ages 35-59 who had torn knee cartilage from common wear. Researchers concluded that exercise therapy showed more positive effects than surgery.

There are exercises and less invasive treatments you can do to stay out of the hospital and improve your quality of life, said Kevin Bozic, MD, orthopedic surgeon and executive leader of Seton’s musculoskeletal services. Ascension Seton is a part of Ascension, the nation’s largest Catholic and nonprofit health care system.

Historically, physicians thought the meniscus, which is part of the cartilage in the knee, may need repairing or smoothing out to reduce pain and swelling, said Bozic, who chairs the department of surgery and perioperative care at Dell Medical School at The University of Texas.

However, this study and many others like it reveal that in some cases, surgery may not be any more beneficial than physical therapy.

“The real take home is you don’t need surgery for degenerative cartilage tears in middle age, which are very common and a normal part of aging,” Bozic said. “It just doesn’t help improve quality of life any more than physical therapy or other less invasive treatments.”

Sudden injury versus wear and tear

Courtesy Dr. Kevin Bozic

This image is of an MRI of a degenerative meniscal tear. Dr. Kevin Bozic, orthopedic surgeon and executive leader of Seton’s musculoskeletal services, said a recent study shows surgery may not be more beneficial than physical therapy in some cases.

The first step in understanding knee pain is determining whether the cause is an acute injury or a degenerative condition, Bozic said. Even when the cause is acute injury, you can still avoid surgery.

If it’s an acute injury, Bozic usually recommends the “RICE” method—rest, ice, compression and elevation of the knee.

“If it’s a chronic, degenerative process, then we think about changing the person’s activities to avoid things that bother it. Often, those are activities that involve impact, running and jumping,” he said.

Other recommended changes include exercises to strengthen the quadriceps and stabilize the knee, and braces to hold the knee in place.

You’re also more likely to need surgery if you have a torn ligament or you’re in later stages of degenerative arthritis.

Non-surgical treatments

There are several methods you can try that are much less invasive than surgery for knee arthritis:

  • Exercise: Building more muscle can actually protect your knee. Look for strengthening, low-impact aerobic exercises to do. Bozic recommends walking, swimming, bicycle, hiking, elliptical, yoga and other exercises that don’t involve running, jumping, or impact to the knee.
  • Weight loss: If you’re overweight, studies have shown that shedding some pounds through a combination of diet and exercise can help ease knee pain. Even losing five percent of your body weight can ease pain and help you move better. Weight loss can also cut down on inflammation in the body, which contributes to joint damage.
  • Painkillers: Try non-steroidal anti-inflammatory drugs (NSAIDs) or Tramodol. NSAIDs like ibuprofen or aspirin can help reduce inflammation.
  • Self-management and education: Understanding how arthritis affects your body, and what therapies and strategies work for you can help a lot. Stretch before playing sports, and avoid activities that put stress joints, such as kneeling. Talk to a health care provider such as a physical therapist for exercise and wellness tips.
  • Acupuncture: The American Academy of Orthopaedic Surgeons says there’s not enough evidence in favor of acupuncture for the treatment of arthritis. But the American College of Rheumatology says it’s worth exploring because some studies show acupuncture can help with pain.