It is an interesting fact that people can have many kinds of defects in their joints, but exhibit no pain.

This is long-known to be true for the lower back, but it can also be true for the knee. For example, when doctors look at a series of MRI scans of the knee and find evidence of meniscal tears or osteoarthritis (both very common and thought to be very painful), the doctors cannot predict which of these patients have pain in their knees and which do not.

So this begs the question, if these defects are found in people with painful knees, should they be surgically treated if many people have the same structural defects but exhibit no knee pain?

The answer, most of the time, is no.

Knee scopes (aka knee arthroscopy)

The typical surgical approach in this circumstance is knee arthroscopy, where a surgeon inserts tools with cameras into the knee through small openings and works to fix the defects seen on an MRI.

The British Medical Journal has reviewed all of the research and outcomes of arthroscopic knee surgeries and has found that there is only “small inconsequential benefit seen from … arthroscopy for the degenerative knee”. (See study here)

All too often, a patient has gone through this invasive procedure and most likely will come out the other end of the surgery no better. Why are we still doing this?

There are, of course, examples of patients who do feel better for a prolonged period following an arthroscopy procedure, but the vast majority won’t.

More appropriate (and less invasive) treatments

Unless a total knee replacement is an option (which often isn’t the case), how can we really help those with knee pain?

If you are thinking cortisone shots, think again! They may temporarily take the pain away, but they also further weaken and deteriorate the surrounding tissues, leaving the joint worse off for the future.

The truth is, pain very often originates from microscopic damage to tissues that need to be repaired. Surgery cannot do this and only the body’s repair mechanisms are the most effective – but they need to be stimulated to do so. This is where prolotherapy can be of great value.

Prolotherapy takes advantage of the body’s own healing mechanisms to repair the painful microscopic damage and restore the strength and durability of the joint. For more information visit our webpage.

There is quite a number of common and invasive medical procedures that take place without the level of evidence that one would expect. If you are interested, this article reviews a few of these.

– Dr. Colin

Why Canada is wasting millions on useless knee surgeries. http://www.cbc.ca/news/health/arthroscopic-surgery-useless-1.4110569