Alternatives to Knee Replacement Surgery

James Jacobsen, 70, knew he would need knee surgery when he saw the x-rays to explain why he was suffering so much pain. It was bone on bone now. But is knee replacement surgery really the only answer? Jacobsen was referred to an orthopedic specialist. At this point he was given information listing the pros and cons of the surgery but also alternative solutions. In this way he could make an intelligent decision about his future. “I’ve got to have my legs under me,” ”I’m not going to have a knee replaced until it’s absolutely necessary” he said.

A study published in September 2012 in the journal ”Health Affairs” found that introducing alternative solutions to knee replacement surgery in Seattle led to 38 percent fewer knee replacements, 26 percent fewer hip replacements, and significantly lower costs for the health system during a period of six months.

This information is especially important as it comes when there is a phenomenal rise in knee surgeries. There are many factors for this rise: an active population of baby boomers now facing osteoarthritis, growing rates of obesity and the continuing improvement of artificial joints. There has been improved communication between orthopedists and their patients recently to help bring this about.

Studies by the Agency for Healthcare Research and Quality and what was published in The Journal of the American Medical Association found that the increase in knee replacement surgery has increased 2.5 times for those middle aged in a period of 10 years and that the surgery for medicare patients has increased 162 percent in 20 years.

Osteoarthritis is the major contributor to this phenomenon followed by obesity. Advertisements for artificial joints has also been a factor.

However, Dr. John Tierney, an osteopath and orthopedic surgeon based at New England Baptist Hospital and Greater Boston Orthopedic Center, who is one of several doctors recommending a more conservative approach said that he tries to help patients forestall the surgery step as long as possible. Some of those delaying tactics are: losing weight of bariatric surgery to treat obesity, changing lifestyles in order to avoid certain activities, strengthen muscles around the joints and taking pain medication to reduce inflammation. Sometimes there can be a benefit to wearing a brace to offset an unbalanced set of legs. Cortison injections are also an alternative treatment against the joint pain. Since no medication exists yet to counter the progression of osteoarthritis, it is important to remember  that artificial joints wear out eventually so delaying the surgery as long as possible makes sense.

Dr. David Arterburn, lead author of the Health Affairs study and a researcher at Group Health Research Institute in Seattle, says “…to make sure that patients understand that there is more than one option when it comes to osteoarthritis treatment.”

Karen Sepucha, of the Health Decision Sciences Center at Massachusetts General Hospital, says that just because you’re ‘clinically appropriate’ for the surgery doesn’t mean you should have it.

To make sure that patients who decide to go through major procedures truly want them, Mass. General now gives patients decision aids for 36 different conditions, including knee osteoarthritis.

Being an educated patient is crucial to making the right decision because even physicians will not be able to guarantee success.

The LEGTUTOR is a physical therapy product that has a dual function. It can be used prior to knee surgery to strengthen the muscles around the knee joint so that surgery will be more successful, less painful and allow for  a more speedy recovery or in fact it may even prevent the need for surgery. Alternatively it can be used as a device to exercise the leg, knee or hip after surgery in order to speed recovery.

The LEGTUTOR is an ergonomic wearable leg brace with dedicated rehabilitation software. The LEGTUTOR rehabilitation concept is based on performing controlled exercise rehabilitation practice at a patient customized level with real time accurate feedback on the patient’s performance. This means that the LEGTUTOR system allows the physical therapist to prescribe a leg rehabilitation program customized to the patient’s knee and hip movement ability at their personal stage of rehabilitation. The LEGTUTOR uses biofeedback to keep the patient motivated to do the exercise practice in the form of challenging games. They are suitable for a wide variety of other neurological and orthopedic injuries and diseases as well as post trauma and orthopedic surgery.

The LEGTUTOR is also used by physical and occupational therapists in combination with the HANDTUTOR, LEGTUTOR and 3DTUTOR for upper and lower extremity rehabilitation. The TUTOR system is used by many leading rehabilitation centers worldwide and has full FDA and CE certification. It is designed for children and adults and can be used at home supported by telerehabilitation. See WWW.MEDITOUCH.CO.IL for more information.


2 responses to this post.

  1. first of all I am very entertained by the picture at the top secondly I do think that surgery should not be the first option so if you can solve it in different ways do it but if it’s absolutely needed then do the surgery.


  2. A very informative blog. Also on tips to forestall the knee surgery rather than rush into it and using an alternative course.


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