Why Surgery should be your Last Resort for Knee Pain

Arthroscopic knee surgery is one of the most common surgeries performed – despite research telling us that it’s not nearly as effective as most people are led to believe. Furthermore, the science tells us that people who do undergo arthroscopic knee surgery are more likely to have knee arthritis that advances rapidly – resulting in a total knee replacement that quite possibly could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

Well… it is until it isn’t. 

The big problem is that arthroscopic knee surgery is actually not necessary for most cases of knee pain. If there is a complication – which exists even with “minimally invasive” procedures – you could end up being worse off than when you went in. Plus – if you never even needed the surgery to begin with – you just put your knee through unnecessary trauma that you’ve got to now heal from. This further delays you from addressing the root cause of your knee pain.

The truth is that most people can get full relief of their knee pain as well as full restoration of knee function without any type of surgery or procedure. This is true for 70-80% of all knee pain cases.

An early research study from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have proven similar results. This means that even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment. 

So why then – despite all this research – are surgeons still performing arthroscopic knee surgery at a higher rate than ever?

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management of knee pain beforehand. If you’ve gotten physical therapy and it wasn’t effective, people are led to believe that the physical therapy “didn’t work”. But more often than not, you just haven’t found the right physical therapist yet – or seen a physical therapy specialist who is an expert in mechanical knee pain. 

And then there’s the elephant in the room…

It’s very common for knee pain to be coming from somewhere other than your knee.

Knee pain can come from your ankle, hip, or back. One study showed that 25% of the time – knee pain is caused by a source in your spine – even when you don’t have any back pain. MRI’s add even more confusion to this. It’s entirely possible to have degenerative changes, a torn meniscus, or advanced arthritis in your knee – and still have your knee pain stemming from a source other than your knee. For example, in a study by Guermazi et al from 2012, they performed MRI’s on 504 people with pain-free knees. They found that 72% of these folks had bone osteophytes – indicating arthritis. And 25% of them had meniscus tears. So it’s important to not jump into knee surgery simply based on MRI findings.

My career has spanned over 2 decades, and I’ve seen many knee surgeries go wrong. Most of the time, it has nothing to do with the procedure itself, but everything to do with an incorrect diagnosis going in. If your knee pain can be resolved conservatively – and you put it through unnecessary trauma (surgery) – there’s a good chance you’re going to have more problems afterwards. If you get knee surgery when your knee problem isn’t even coming from your knee – then you’re definitely going to have problems afterwards.

The moral of this story is to make absolutely certain that 1) your knee problem is really a knee problem and 2) you’ve fully exhausted all conservative therapy options (including specialized physical therapy) before going under the knife.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Knee Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or request a copy of her Free Guide: 7 Easy Ways to Get Rid of Knee Pain – click here.