A doctor with a bad knee runs into one-size-fits-all medicine

myleftknee01It took me three months of physical torture before I diagnosed my problem: I was suffering from one-size-fits-all medicine.

I am one of more than 750,000 Americans who this year will have a total knee replacement, the most common orthopedic operation. Most people do well with the standard physical therapy protocol, but there are many who have a rough rehab.

My knees went bad as a teenager because of OCD — not obsessive-compulsive disorder, but a rare condition known as osteochondritis dissecans. It wreaked havoc on both knees with plenty of pain and frequent dislocations, ultimately leading to extensive surgery just before I started medical school at age 20.

Over the next four decades, I progressively curtailed activities including running, hiking, tennis and even elliptical exercise, while increasing my reliance on anti-inflammatory medications to deal with the pain. After injections of steroids and synovial fluid directly into the joint failed, it was time to consider getting a new knee. My orthopedist told me I was a “perfect candidate” being relatively young (I was 62), thin and fit; he said the only concern would be a risk — 1 to 2 percent — of infection. Nothing else.

By Eric Topol | The Washington Post

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