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Are we just aching for a surgical fix? Part 1 of 3. Be prepared to be surprised...

11 Aug
A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee
N Engl J Med 2002; 347:81-88 July 11, 2002

Recently, while reading Bruce Lipton's Biology of Belief, I became aware of a study done in 2002 evaluating the effectiveness of surgery for debilitating knee pain related to arthritic changes in the joint. Arthroscopic knee surgery for osteoarthritis is now quite common. People report good results. Surgeons know it works. But some researchers felt that WHY the surgery works was still a question to be answered.

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So they set up a study. 180 people were randomly divided into two groups. One group, a placebo group, underwent a sham surgery. Yep...they received skin incisions and underwent a simulated debridement without the insertion of the arthroscope. The other group received the real surgery.
The results are shocking even to me (who isn't big on surgical interventions). Over 24 months, there was no clinically significant difference in outcomes for the two groups.  Both benefitted.

This particular study raises questions for me, such as:
  • Do patients "comply" (a nasty word but it is what the medical profession uses) better with therapy after the surgery because they "now have confidence it will get better?
  • Does the surgery force a slowing down and working the plan attitude?
  • Do therapists' mindsets change, thereby improving the quality of their interaction with patients?
  • Is the standard protocol used for post surgical rehab different than that used when a person presents with knee pain from osteoarthritis?
Read the study first hand. http://itybityurl.com/11671

Enter the dialogue.
What does this mean to us as patients wanting to heal?
How can we determine the best path?
When are we simply in too big of a hurry when life has its own rhythm? All are questions for me.

Tomorrow I will post on a recent study comparing knee surgery for torn anterior cruciate ligament and conservative treatment. I bet you know already what the results will be....

submitted by Cynthia Allen

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