Knee Arthroscope Vs Conservative Care

Knee Arthroscope

Knee Arthroscope

We accept the marriage between art and science in medicine. An “art” because some people are wonderfully talented in the way they deliver medicine and a “science” because we can test those ways repeatedly across many populations of people over time to prove what is effective.

This method advances medicine repeatedly! By helping people know the right treatment for their condition and equally important… what is not right for their condition.

Just in my lifetime, I’ve seen several advances in medicine. Surgeons are used to casting the whole leg from hip to toes after a knee surgery. I bet you remember seeing a lot more people in casts than you do now.

Your grandparents may have put butter on burns to try and “cool it off”.

Neck surgery used to go in from the back but now they go in from the front. Same with hip replacement surgery.

A recent change to a common medical procedure we are seeing science debunk over and over is the “knee clean up” surgery.

I’m sure you’ve heard of it.

It’s the one where they go into the knee with small instruments, called arthroscopes, to clean up the small tears in the meniscus and cartilage to try and “smooth” it out. A good idea in theory. Because the more debris you have floating around in the knee can’t be a good thing, right?

Turns out, it doesn’t matter. Once you’re over 40, It’s very common to have cartilage, meniscus tears, osteoarthritis, and even narrow joint space to show up on x-rays and MRIs in the knee. AND not have pain or difficulty with movement!

Arthroscopic knee surgery is still one of the most common surgeries performed.

Furthermore, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly. Resulting in a total knee replacement that could have been avoided.

Watch this video to learn more about knee pain.

Most people can get pain relief and restore function in their knees without ever getting surgery.

One of the earliest studies from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have shown similar results – that even if you’ve got a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures more than ever.

In some cases, it’s just what the surgeon knows, and they haven’t kept up with the research. Other times it’s due to poor conservative management and not giving the RIGHT therapy enough time.

In our office, we often see people after they’ve tried regular physical therapy first. Since we have a more specialized approach, and we’re able to spend more time with our clients to get to the root cause of the breakdown, we tend to get better results and can help clients avoid surgery altogether.

However not all physical therapy clinics can afford to do this.

In those cases, people are led to believe that the physical therapy “didn’t work”, and they get scheduled for surgery.

But what’s the big deal really?

If outcomes are the same regardless of whether you get surgery or not – why not just get it? It’s quicker and far more convenient than going to weekly therapy appointments…

But – despite the term “minimally invasive” – it’s still surgery.

You will have bleeding, swelling, and recovery time. Any trauma that happens to the soft tissue in and around the knee has to heal. There’s also the risk of infection, which comes with a whole set of different complications.

And then of course there’s the elephant in the room that nobody likes to talk about…

I’ve seen many of these arthroscopic surgeries performed that had clients feeling WORSE than before surgery. Because it turns out the procedure wasn’t even necessary. Luckily we’re able to still get them better. But it’s frustrating and discouraging for our clients.

In general, despite how small the procedure may seem, you want to avoid surgery whenever possible.

Although small, the risks that can happen with surgery simply aren’t worth it – especially when you can get the same results from natural, conservative treatment.

For some, arthroscopic knee surgery really is necessary.

But it can usually be avoided.

If you’re currently suffering from knee pain and want to learn more about what you can do to not only avoid surgery – but help get rid of knee pain naturally and on your own –


Nick Hunter, PT, DPT

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