Surgery is not always the best and rarely a miracle solution.
It has been almost 15 years since the atroscopic knee surgery (meniscus tear-lesion) was indicated and subsequently not recommended by another doctor. My ideas about diagnosis and surgery were simple. I’ve damaged something in my knee and it needs to be fixed. In hindsight, I can see how rosy I imagined my knee “fix” to be. Years later, I was surprised to discover that this type of surgery, which is one of the most common orthopaedic surgeries, is commonly performed without any clear evidence of its effectiveness.
Let’s start gradually. Arthroscopic partial (partial) meniscectomy (APM) is one of the most common knee surgeries. It is also one of the most common orthopaedic procedures overall. In a 2013 study, 146 patients underwent real or sham (placebo) surgery. One year after the procedure, the two groups of patients were compared and found no significant differences in pain parameters.
Can one study be sufficiently telling? Of course not. Hence A 2019 meta-analysis including 10 studies is strong evidence. What was the authors’ conclusion? Shocking! “Performing APM (arthroscopy) in all patients with knee pain and meniscus lesions is not appropriate. Surgical treatment should not be considered the first choice intervention. However, in patients without osteoarthritis, APM may have a small to moderate benefit compared with physiotherapy.”
How did my knee turn out in the end? After almost 15 years since the planned surgery from which it came and after 8 years of top training (I won several Slovak champion titles in freestyle wrestling) I can’t remember which knee it was.
What is actually the message of this article? Don’t rush your knee surgery, try to take full advantage of a conservative solution. I’m not saying that surgeries are bad. But if you decide to have surgery anyway, at least you’ve had good pre-operative physiotherapy, which will come back to you in post-operative rehabilitation.
The theory is excellent but it must be the basis for the follow-up practice. I will try to share with you some of the simplest and often effective therapy techniques that we indicate on the basis of a detailed examination in our centre.
Knee pain can often originate in the muscles around the hip joint. They may contain reflex changes, active trigger points that can radiate pain up to the knee. Their release very easy.
Knee pain can be according to Mulligan’s concept also caused by a positional error in the position of the knee joint. Basic autocorrection exercises are easy to master and can be used as a quick help.
Recommendation for the end? Any invasive therapy is irreversible, invest the maximum in your health and make the most of your options. To identify the causes of musculoskeletal pain , a detailed examination is necessary, not only by a doctor but also by a quality physiotherapist.
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