BOBBING FOR ANSWERS – NEWS & COMMENT
Recent Niche News
The Family Circle of Gout (Posted 2/25/14 in Gout News.)
Gout Research: Science Turns Against Wine (Posted 2/14 in Gout News)
The Case for Options to Surgery
A lot of orthopedic surgeries that are done for rotator cuff tears and other conditions are not actually necessary, suggests Dr. Howard Luks, Associate Professor of Orthopedic Surgery at New York Medical College and Chief of Sports Medicine and Arthroscopy at Westchester Medical Center.
We’ve touched on this in a number of our Bobbing for Answers Web pages. On the Plantar Fasciitis Surgery page, for example, we take note of the University Foot & Ankle Institute’s comment that the need for plantar fasciitis related surgery is “exceptionally rare;” and we have noted how reluctant are orthopedic surgeons to go the surgery route without first exhausting the possibilities of self-cure and minimally invasive treatments.
In our Rotator Cuff Solutions pages, we’ve taken note of similar reservations about surgery. On our Rotator Cuff News & Tips page, for example (where we have also referenced Dr. Luks’ cautionary view of the topic), we’ve noted one study under the heading “Surgery Not Necessary?” Described in an article in The Journal of Musculo-Skeletal Medicine, the study indicated that “three out of four (75% 117 patients studied) patients with massive rotator cuff tears were able to forego surgery in favor of “conservative measures…The results were significantly better than those for the 30 patients who ultimately required surgery.”
“Many patients are under the unfortunate impression that if something is torn it must be fixed,” according to Dr. Luks. “Nearly all patients who are informed that they have a torn meniscus or a torn rotator cuff will immediately conclude that they need surgery to repair the problem.”
So writes Dr. Howard Luks in a July 22, 2013 commentary on the Rheumatology Network, “When Not to Fix: Thoughts of an Orthopaedic Surgeon.” However, writes Dr. Luks, “Patients who are informed fully about the various risks and benefits of surgical and nonsurgical measures generally tend to opt for less-invasive procedures.”
For example, according to Dr. Luks, “It has been estimated that anywhere from 15% to 20% of knee replacements and arthroscopy for various orthopedic conditions are unnecessary. I suspect that actually this number may be higher; however, the data is lacking.”
“One driving force that is emerging in our high-tech, low-touch approach to healthcare is our tendency to rely far too much on technology such as MRI findings, and too little on our physical exam findings and on the story our patient is telling us” writes Dr. Luks.
“Are we treating these patients?” he asks. “Or are we treating their MRI findings?