How Much Does Knee Surgery Really Benefit?
A study published late last month in The New England Journal of Medicine is raising intriguing questions about how best to treat a lacerated anterior cruciate ligament. For the study, employees from Lund University in Sweden recruited 121 young adults who had injured their A.C.L.’s. The volunteers, between 18 and 35, were physically dormant and many were competing athletes. They positively, rather fearlessly, to be randomly appointed to one of two groups and accept thoroughly different treatments for their impaired A.C.L.’s. The first group began physical therapy and then underwent surgical reconstruction of the ligament, contemplated by many people to be the right choice for harmed athletes. The second group obtained only physical healing treatment, with the alternative to have the surgery later. Twenty-three subjects of that group did eventually have the operation. (For those fortunate enough not to be individually informed with A.C.L. medical procedure, repair involves replacing the injured ligament with tissue from elsewhere in your own leg or from a cadaver.)
Over two years, the injured knees were valuated using a comprehensive numerical score that rated discomfort, function during activity and other measures. At the time of the earliest abrasion, the knee also had been scored. At the end of the two years, both groups showed noticeable recovery. The scores for the surgically renewed knees had risen by 39.2 points. The scores for the more conservatively treated knees also had risen, by 39.4 points. In other words, the outcomes were virtually identical. Even though an epidemic belief that medical procedure leads to a better knee, the results showed that surgically reconstructing the A.C.L. as soon as possible after the tear “was not superior” to more conservative treatment, the study’s authors wrote. The findings suggest, the authors concluded, that “more than half the A.C.L. reconstructions” currently being conducted on injured knees “could be avoided without adversely affecting outcomes.”
This possibility should rebound across playing fields nationwide, where, at the moment, preseason high school, collegiate and adult-league sports practices are under way, with a concomitant surge in A.C.L. tears. By one assessment, as many as 1 in every 556 fit, active people will tear an A.C.L. – particularly if they participate in sports that involve habitual pivoting and landing, like soccer, football, tennis, skiing and basketball. At the same time, the appeal to medicate the injury with surgery appears to be increasing. The “conclusion among most surgeons and patients is that surgery is a ‘must,’ at least if you aim to go back into an active lifestyle,” the Swedish authors of the study e-mailed in response to questions.
Joseph Rongo is co-founder of ASIS, a Massage School with campuses in northern Arizona, Chicago, and partnerships with universities. He envisions massage therapy education and practice to be solid steps toward self-empowerment and world peace.
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