MANY BONE OR JOINT SURGERY IS NOT BETTER THAN NONSURGICAL OPTIONS

New York Times reports recently, for many common problems of the knee, hip, shoulder, spine and wrist, surgery may be no more effective than options like exercise, physical therapy and drug treatments!

“Hip and knee replacements, surgery for carpal tunnel syndrome and other orthopedic procedures are among the most common elective surgeries performed today, but they involve cost, risk and sometimes weeks or months of recovery”

A paper published in BMJ, found two surgeries for carpal tunnel syndrome and total knee replacement are superior over other treatments. 

For six other common surgeries, randomized trials found little advantage over interventions like exercise, weight management, physical therapy and drug treatment. These surgeries are 

1 Arthroscopic operation to repair the anterior cruciate ligament (ACL),

2 operation to repair the rotator cuff

3 surgery for shoulder impingement

4 Lumbar spine decompression

5 meniscectomy

The researchers found no controlled trials that had compared hip replacement or knee cartilage repair with nonsurgical care.

In summery, doctors should discuss both operative and the best nonoperative care with patients so that patients can make informed choices.

Ref

1. https://www.nytimes.com/2022/01/04/well/bone-joint-surgery.html

2. NYT article in Chinese: https://mp.weixin.qq.com/s/WttlJTBuQ-mcL_iqBFebGA

3. Original BMJ paper: https://www.bmj.com/content/374/bmj.n1511