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Knee "Scopes"...To Therapy, Or Not To Therapy?


An arthroscopic knee surgery is a type of surgery that allows the surgeon to view the inside of the knee without making any big incisions. They will typically make a couple of small incisions at the front of the knee and insert a tiny camera and small instruments to correct the tissue damage.

I’ve recently had a few conversations with people who have been told by their orthopedist that they need an arthroscopic knee surgery for their torn meniscus or worn out cartilage. Interestingly, this recommendation often comes before any conservative measures (such as physical therapy) have even been offered or discussed.

Is this because knee arthroscopies are such a huge success that conservative measures can be bypassed?

A systematic review published by the British Medical Journal in 2017 thinks otherwise.

The article titled, Knee Arthroscopy Versus Conservative Management In Patients With Degenerative Knee Disease: A Systematic Review concluded [that] “Over the long term, patients who undergo knee arthroscopy versus those who receive conservative management strategies do not have important benefits in pain or function.”

This begs the question why so many people are being offered surgery before therapy.

Regardless of how small the incisions are, it’s still a surgery and there are risks involved. There’s anesthesia, medications and time away from work that will inevitably follow. These are serious considerations. What if you’re not able to recover as quickly as you thought? How much work will you be able to miss?

If you’re not the type to rush into surgery, it seems as though conservative management would be a valuable option to consider. Speaking from the standpoint of a physical therapist, we’ve helped many people avoid a potential knee surgery and still be able to stay active and do what they enjoy most in life.

It’s important to also note that not everyone responds to conservative management and may choose to go the route of surgery. If that’s the case, I would strongly urge that individual to set up physical therapy following surgery. You may be surprised to know that a lot of surgeons don’t immediately recommend physical therapy. A good physical therapist will be able to help you reduce the early pain and swelling and then help you regain your flexibility, walk normally and steadily get back to your day-to-day activities in a safe and progressive manner.

Key Takeaways:

  1. Not everyone benefits from a knee surgery – even if your MRI says you have a torn meniscus or worn out cartilage.

  2. According to a study published by the British Journal of Medicine there are no important long-term benefits to having a knee arthroscopy compared to conservative management.

  3. If you choose to go the route of surgery, get set up with a physical therapist as soon as possible following surgery to help speed along your recovery.

If you’re considering a knee arthroscopy and want advice on what to do and what to expect, we’re here to help. Call us anytime at (504) 407-3477 or send us an email if that’s easier at info@tandempt.com.

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