Avoiding
Knee Surgery
Excerpt
By
Colette
Bouchez, HealthScoutNews
(HealthScoutNews) -- Aging weekend warriors, listen up!
Whether you're a jogger, a tennis player or a baby boomer who enjoys
all sports, if your knees are starting to give out, skip the thought
of surgery and just give them a rest.
That's the advice of the Mayo Clinic's Dr. Arlen D. Hanssen,
who offered those words of caution in a report today at the annual
meeting of The American Academy of Orthopaedic Surgeons in Dallas.
"Unless the pain is such that it interferes with activities
associated with normal living, baby boomers should not be encouraged
to have knee surgery, but instead be advised to modify their athletic
activities to reduce stress on their knees," Hanssen says.
Indeed, Hanssen is one of a growing number of orthopedic surgeons
who suggest boomers treat their knee pain more conservatively
-- starting with swapping fitness activities like jogging and
basketball for more knee-friendly exercise such as swimming, riding
a stationary bike or even walking.
"If need be, medication and physical therapy can also be
added to help manage the pain," says Hanssen, a professor
of orthopedics at the Mayo Medical School.
What's not appropriate, he says, is automatically turning to
surgery -- either ligament repair or even total knee replacement
-- before you try the conservative approach.
New York City orthopedic surgeon Dr. William McCauley calls
the advice sound.
"Only after all other treatment possibilities have failed
to bring relief -- and that includes stopping the offending fitness
activity -- then, and only then, do we recommend surgery be considered,"
says McCauley, director of the Center for Hip and Knee Replacement
at Columbia Presbyterian Medical Center.
The idea to cut back on boomer operations grew out of the recognition
that a patient's age has a lot to do with how well -- and how
long -- the "new" knee will last, Hanssen says.
"While older folks have usually stopped their high level
of activity by the time they are getting a knee replacement, not
so for younger people," he says.
Boomers are far more likely to want the knee surgery so they
can continue leading their active lifestyle, including participating
in the sport that harmed their knees to begin with, Hanssen says.
Inevitably, the new knee wears out and the pain returns, he
says.
The other common surgical option -- a ligament repair, often
done for injuries such as a painful tear near or around the knee
-- works well for people in their 20s or 30s. However, it's not
a good idea for middle-aged fitness buffs, Hanssen cautions.
"Most of the time, younger adults have not yet seen arthritis
develop in their knee, so the ligament surgery will help them,
and, most importantly, is likely to relieve their pain,"
he says.
By comparison, a boomer with a similar problem is likely to
have some arthritis in the knee as well. So, surgically repairing
the ligament won't do the trick, Hanssen says.
"They'll still have the arthritis to contend with, so the
operation is not going to give them that pain relief they are
seeking," Hanssen says.
Instead, he encourages a gentler course of treatment involving
rest, physical therapy and, if necessary, medications to ease
inflammation and pain.
Ironically, surgery often leaves boomers exactly where they
would be if they had taken the more conservative approach, McCauley
says.
"They find they still have to cut down or change their
fitness activities. In addition, they can find themselves in need
of medication or therapy as well. So, why go through the surgery?
Why not just make these changes in the first place and see if
they help," McCauley says.
Since doctors are the ones who perform these operations, it's
clear they play a major role in any inappropriate surgeries. However,
Hanssen says boomer athletes are at least partially to blame.
"Many of them hear or read about these surgeries. They
read about pro sports figures who have them and go back to the
game, and they think they can do the same thing. So they push
hard for the surgery, and sometimes doctors have no choice but
to give in," Hanssen says.
The best advice, for both doctors and boomer patients, is to
be selective about treatments and always make surgery the last
resort, Hanssen and McCauley say.
What To Do: For more information on knee injuries and
potential treatments, visit The
Center for Hip and Knee Replacement. You can also look at
this list
of resources on knee surgery.
Reference
Source 89
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