If you’ve been told you are “bone on bone” or have no cartilage or it’s irreversible & knee joint replacement surgery be skeptical. It may be true but it isn’t a fait accompli
“37% of the subjects had an improvement (≥1-point decrease) in cartilage defect score in any knee compartment during 2.3 years”
“Studies suggest about 1 in 4 adults suffer from chronic knee pain. The number of sore, swollen and stiff knees has risen 65 percent in the past four decades and the increase can’t be explained by aging or obesity alone”
“experts say there is strong interest in nonsurgical alternatives to cut joint pain and provide more mobility and a better quality of life.”
“When the knee cartilage is gone and the joint pain severe — known as stage four or end-stage knee disease — the treatment options are painkillers and total knee replacement, the most commonly performed inpatient surgical procedure for people 45 and older in the United States.”
“Knee replacement surgery outstrips the 500,000 coronary artery bypass surgeries performed yearly. If trends continue, estimates are that nearly 1.3 million Americans will undergo knee replacement by 2030.”
“research suggest that pain persists in as many as 20 percent of knee replacement patients.”
“Potential risks of knee replacement surgery range from infection to blood clots.”
“The range of motion that you “have going into surgery with is what you will come out with,” said Elizabeth Matzkin, an orthopedic surgeon at Brigham and Women’s Hospital in Boston”
“Medications, from nonprescription ibuprofen to powerful prescription drugs, can help counter joint pain by reducing inflammation. But long-term use of these medications also comes with potential serious side effects, including the risk of stomach bleeding.”
“many other treatments are now available and are often advertised for knee relief. They include acupuncture, external braces, dietary supplements glucosamine and chondroitin sulfate, needle lavage, injections of growth factor, stem cells or hyaluronic acid, arthroscopy to repair meniscus tears, use of acetaminophen, steroid injections, opioid drugs and pain patches.
Yet, in its 2013 guidelines, the AAOS either recommended against all of these treatments or found inconclusive evidence that they work.”
“Since cartilage cells don’t have their own blood supply, it has long been thought that these cells could not regrow. But some research suggests that may be wrong.
Among the evidence showing that cartilage can heal is a 2006 study of 325 people, average age 45. In the two-year study, which simply followed the natural history of these patients, 37 percent of participants showed improvements in cartilage as measured by MRI,”
“Finding the “sweet spot” for injured knees can also be tricky and varies widely from person to person. It takes just the right amount of movement and weight-bearing pressure to bathe the cartilage cells in joint fluid, allowing them to be nourished and recover without causing more joint damage. It means gently moving joints that may be stiff, swollen and painful.”
#Healthy_Aging
#The_Inactivity_Crisis
#Excessive_Imaging_for_Musculoskeletal_Problems
#Overutilization_of_Surgery
#Knee
https://jamanetwork.com/…/jamainternalme…/fullarticle/410037
Posted to FB on 2019-11-24 20:54:31
