Richmond News Now

How to Avoid Knee Replacement Surgery

 Breaking News
  • No posts were found

How to Avoid Knee Replacement Surgery

December 05
01:06 2019
The bad news is that knee replacement surgery isn’t the cure-all people think it is. The good news is that there are better, cheaper, easier options.

The typical cause of total knee replacement surgery is a torn meniscus. The meniscus is the disc that cushions the knee and is crescent-shaped. While this does not always cause pain, around one third of those over 50 years old have a torn meniscus, and those with arthritis have a higher chance of this.

Sufferers of chronic knee pain are treated for arthritic knees, given medications, knee braces, and corticosteroid injections to treat the pain, but this does not always work, sometimes worsens the situation. Medical researchers at Boston University School of Medicine found that corticosteroid injections run the risk of accelerating joint destruction and bone loss. This common form of pain management for knee pain can actually shorten the patient’s road to total knee replacement surgery. In fact, the Mayo Clinic found that the rate of total knee replacement surgery has doubled in the United States since 2000. Since these replacement knees have a 20-year lifespan, 35% of men and 20% of women who get total knee replacement surgery under the age of 60 will need a revision in their lifetime. The Washington Post reported on December 22nd 2018, “The 723,000 knee replacements performed in 2014 cost patients, insurers, and taxpayers more than $ 40 billion,” and this number is projected to continue to rise with the aging population and rising prevalence of obesity. 

Unfortunately, the needs of an aging and increasingly obese population with high rates of osteoarthritis and torn meniscuses is not the only reason the rate of total knee replacement is on the rise, and patients are undergoing this procedure at younger ages. The other factor is greed.

“Medical advertising is a big part of the problem,” says orthopedic surgeon Nicholas DiNubile. “Its purpose is to sell patients on the procedures.”

Surgery is sold as a quick-fix solution that gets the patient back to doing what they used to do before severe knee pain. Following surgery, chronic pain persists in one third of total knee replacement patients, and one in five report being dissatisfied with the results of this major – and costly – surgery. While the efficaciousness of total knee replacement surgery is being oversold, the possible risk factors are at the same time underreported in medical advertising. Generally, about 0.5-1% of patients die within 90 days of undergoing knee replacement surgery. The University of Florida published in the Journal of Alzheimer’s Disease that for total knee replacement surgery patients 60 years and older, 48 hours following the surgery, 25% of these patients showed a decline in brain connectivity in at least one brain region, and one in seven patients showed connectivity declines that spanned all brain networks, while patients 60 years old and over who did not have this surgery did not display these same declines.

If treating patients with chronic knee pain from osteoarthritis with knee braces, physical therapy, and pain management medications and injections does not prevent total knee replacement surgery, and total knee replacement surgery does not always work either and comes with notable risks, maybe we’re missing a crucial piece of the knee pain puzzle. While osteoarthritis in the knee is generally present with severe knee pain that leads to total knee replacement surgery, and tends to be treated as the cause of knee pain, Kim Gladfelter reported in the Los Altos Town Crier in November of 2018, “There are millions of people walking around each day who have arthritis in their knees but no pain.”

But what if osteoarthritis is not the root cause of knee pain? What if something else is going on?

Florida wholistic physical therapist Craig Cohen sees the problem of knee pain in the context of the whole body. In his experience, knee pain is an indicator that the root cause elsewhere in the alignment and mechanics of the body.

“So many of our healthcare choices are aimed at turning off the pain, rather than heeding its message,” explains Cohen. “With integrative physical therapy, we don’t treat the arthritic knee; we treat the entire person. We identify how excessive strain is put on the knees from body misalignment, poor body mechanics, and muscle weakness, and develop an individualized treatment plan that starts in the office and continues at home.”

As it turns out, listening to knee pain and opting for physical therapy that identifies and addresses the root causes of the knee pain can work just as well as total knee replacement without risk of complications or pain persisting after surgical intervention. A study published in September of 2018 in the Osteoarthritis and Cartilage Journal that used two parallel randomized and controlled trials to test the outcomes of total knee replacement and non-surgical treatments on knee pain. The study followed 100 adults with a mean age of 66 who were eligible for knee replacement surgery and had moderate to severe levels of knee pain. Half underwent total knee replacement right away, and half were treated with physical therapy. Researchers found that patients who were diligent in their physical therapy improved as much as those who had knee surgery in just six months to a year and avoided the risks patients with surgery endured. Those who underwent surgery instead of physical therapy were four times as likely to develop blood clots, infections, and require another medical procedure that required anesthesia. Of those who underwent physical therapy instead of surgery, two years later only one third opted to have knee surgery.

Study leader Dr. Jeffrey Katz reported, “It would be quite reasonable to try physical therapy first because the chances are quite good that you’ll do quite well.”

Researchers in a federally funded study at seven major universities and US orthopedic surgery centers followed 351 patients with torn meniscus and arthritis, some who were assigned immediate surgery and other who were assigned physical therapy. They found physical therapy is most successful when a patient has an average of nine session and keeps up with regular physical therapy exercises at home. Persistence is the key to success, and it is much cheaper with far less risk factors. 

Following knee surgery, those who have the most success with pain management and regaining their abilities from before chronic knee pain are the ones who adhere to their physical therapy regimen, and whose providers look at the big picture of their health and wellness rather than just the knee.

“We offer patients a physical therapy immersion program tailored to the root causes of their knee pain,” says Cohen. “It’s an intense program where a patient might come in for three, four, five days in a row for therapy. They’ll receive five hours of therapy per day, we bring in a lot of modalities. From there, we send them home with exercises to do on their own.”

Physical therapy directed at the actual root causes of chronic knee pain can be just as effective as total knee replacement surgery, even in patients with advanced osteoarthritis. Physical therapy runs a lower tab and less risk of complication if the treatment regimen treats the whole body and not just the knee.

Craig Cohen and his team have two Integrated Physical Therapy and Wellness Florida locations, one in North Miami, and another in Hallandale Beach. To learn more about working with Cohen to develop an individualized physical therapy regimen to meet your health and wellness goals, visit https://www.iptmiami.com/ or call 305-967-8976 for the North Miami Location or http://www.westfloridamfr.com/ or call 954-458-5700 for the Hallandale Beach Location.

Video Link: https://www.youtube.com/embed/q3fQW4-h_8s

Media Contact
Company Name: Sheila Danzig Marketing
Contact Person: Sheila Danzig
Email: Send Email
Phone: 9544450107
Address:15970 W. State Road 84 #432
City: Fort Lauderdale
State: FL 33326
Country: United States
Website: http://sheiladanzig.com/