Many of the procedures people undergo to counter chronic knee pain in the hopes of avoiding a knee replacement have limited or no evidence to support them. Some enrich the pockets of medical practitioners while rarely benefiting patients for more than a few months.
I wish I had known that before I had succumbed to wishful thinking and tried them all.
After 10 years of jogging, decades of singles tennis and three ski injuries, my 50-plus-year-old left knee emitted clear signals that it was in trouble. I could still swim and ride a bike, but when walking became painful, I consulted an orthopedist who recommended arthroscopic surgery.
The operation, done with tiny incisions through a scope, revealed a shredded meniscus, the cartilage-like disc that acts like a cushion between the bones of the knee joint. The surgeon cleaned up the mess, I did the requisite postoperative physical therapy, then returned to playing tennis, walking, cycling and swimming.
Fast forward several years until increasing pain forced me off the court and X-rays revealed bone-on-bone arthritis in both knees. A sports medicine specialist suggested a series of injections of a gel-like substance, hyaluronic acid, meant to lubricate the joint and act as a shock absorber. The painful, costly injections were said to relieve knee pain in two-thirds of patients. Alas, I was in the third that didn’t benefit.
With walking now painful and my quality of life diminished, I finally had both knees replaced, which has enabled me to walk, cycle, swim and climb for the last 13 years.
Serious questions are now being raised about the benefits of the arthroscopic procedures that millions of people endure in hopes of delaying, if not avoiding, total knee replacements.
The latest challenge, published in May in BMJ by an expert panel that systematically reviewed 12 well-designed trials and 13 observational studies, concluded that arthroscopic surgery for degenerative knee arthritis and meniscal tears resulted in no lasting pain relief or improved function.