Home > Stem Cell News and Resources > Stem Cells in the News > BAD KNEES OR HIP? DON’T FALL FOR THIS TRAP!

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Release date: 9/24/2015

A half million suckers a year fall for these unnecessary, but very profitable, treatments!

By Dr. Mercola,  North America’s well-known and popular naturalist MD

Arthroscopic knee surgery for osteoarthritis is one of the most unnecessary surgeries performed today, as it works no better than a placebo surgery.

Proof of this is a double blind placebo controlled multi-center (including Harvard’s Mass General hospital) study published in one of the most well-respected medical journals on the planet, the New England Journal of Medicine(NEJM)1 over 10 years ago.

Despite this monumental finding, some 510,000 people in the United States undergo arthroscopic knee surgery every year.2 And at a price of anywhere from $4,500 to $7,000 per procedure, that adds up to billions of dollars every year spent on this surgery.

Osteoarthritis of the knee is one of the primary reasons patients receive arthroscopic surgery. This is a degenerative joint disease in which the cartilage that covers the ends of the bones in your joint deteriorates, causing bone to rub against bone.

Arthroscopic knee surgery is also commonly performed to repair a torn meniscus, the crescent-shaped fibrocartilaginous structure that acts like a cushion in your knee.

Many might think that this problem, surely, would warrant surgery. But recent research3 shows that physical therapy can be just as good as surgery for a torn meniscus, adding support to the idea that when it comes to knee pain, whether caused by osteoarthritis or torn cartilage, surgery is one of the least effective treatments available...

Physical Therapy as Good as Surgery for Torn Cartilage and Arthritis
The featured study, also published in NEJM,4 claims to be one of the most rigorous studies yet comparing treatments for knee pain caused by either torn meniscus or arthritis. According to the Washington Post:5

“Researchers at seven major universities and orthopedic surgery centers around the U.S. assigned 351 people with arthritis and meniscus tears to get either surgery or physical therapy. The therapy was nine sessions on average plus exercises to do at home, which experts say is key to success.

After six months, both groups had similar rates of functional improvement. Pain scores also were similar.
Thirty percent of patients assigned to physical therapy wound up having surgery before the six months was up, often because they felt therapy wasn’t helping them. Yet they ended up the same as those who got surgery right away, as well as the rest of the physical therapy group who stuck with it and avoided having an operation.”

Another study6 published in 2007 also found that exercise was just as effective as surgery for people with a chronic pain in the front part of their knee, known aschronic patellofemoral syndrome (PFPS), which is also frequently treated with arthroscopic surgery.

The study compared arthroscopy with exercise in 56 patients with PFPS. One group of participants was treated with knee arthroscopy and an eight-week home exercise program, while a second group received only the exercise program. At the end of nine months, patients in both groups experienced similar reductions in pain and improvements in knee mobility.

A follow-up conducted two years later still found no differences in outcomes between the two groups.
In an editorial about the featured study,7 Australian preventive medicine expert Rachelle Buchbinder of Monash University in Melbourne urges the medical community to change its practice and use physical therapy as the first line of treatment, reserving surgery for the minority who do not experience improvement from the therapy.

“Currently, millions of people are being exposed to potential risks associated with a treatment that may or may not offer specific benefit, and the costs are substantial,” she writes. “These results should change practice. They should also lead to reflection on the need for levels of high-quality evidence of the efficacy and safety of surgical procedures similar to those currently expected for nonoperative therapy.”


RSCI has known since 2010 that Stem Cells plus Platelets gives the knee patient his life back while surgery is a farce.  Now the rest of the world can take note.  Three of RSCI’s “Approved 15” are expert at knee replacements.  Cost runs around $10k and is available in the USA!!

Activity lower than hoped after knee replacement
(Reuters Health) - After recovering from knee replacement surgery, patients' physical activity levels with their new joint were significantly lower than what they expected going in, in a new survey.

"My take is that total knee replacement is primarily for pain relief, it's not a lifestyle intervention," said Ewa Roos, an osteoarthritis researcher from the University of Southern Denmark in Odense, who wasn't involved in the study.

After surgery, "you need to change your lifestyle, you need an exercise intervention to improve your recreational function," she told Reuters Health.

Knee replacement surgery, also called arthroplasty, involves replacing damaged cartilage and bone in the knee with an implant.

Dina Jones, the lead author of the study from West Virginia University in Morgantown, said most people who have the surgery are pleased with the results in terms of having less pain and gaining more day-to-day function.

But less is known about their hopes for recreational activities, such as participating in sports, yoga or gardening, and whether they are fulfilled.

Jones and her colleagues surveyed 83 patients with arthritis who were about to have a knee replaced, then questioned them again one year after the procedure.

At the time of surgery, study participants reported spending about two hours a week being active, mostly doing moderate-intensity activities such as yard work, strength training and walking.

The patients had high hopes for their post-surgery selves, expecting to spend about 23 hours per week exercising one year out.

In the second set of surveys a year after surgery, people were indeed more active than before -- but not as active as they had anticipated.

Rather than 23 hours a week, patients spent about 11 hours a week being physically active, according to findings published in The Journal of Arthroplasty.

Jones said the reason people's expectations don't match reality is likely because those expectations are rarely brought up in pre-surgery conversations.

Surgeons and patients don't typically discuss long-term exercise abilities following surgery, but usually focus on the knee's function immediately after the operation, researchers said.

"I think patients' priorities are, 'Am I going to be able to walk, am I going to have to use a cane or a walker?'" Jones said. "People aren't looking at whether down the road, 'Am I going to be able to golf or walk down the road or cycle?'"

Because patients don't always know what to expect, they may hope the surgery will let them exercise as much as when they were younger and not in as much pain, Jones said.

And people are at their worst movement-wise right before surgery -- when participants first answered the survey -- so they may also feel they can only improve from there.

Even if surgeons don't always discuss long-term exercise goals with patients, "from the data we've collected I don't see anything that says physicians are telling people they'll have more function than they used to," Jones told Reuters Health.

She and her colleagues are working on developing educational pamphlets and presentations that would help people manage their exercise-related expectations for after knee replacement.
Roos said it's important for doctors to have explicit conversations about how physically active knee replacement patients can expect to be in the future -- both for day-to-day activities like bathing and grocery shopping and for exercise.

People can be disappointed from having expectations that are too high, she said.

On the other hand, "if you don't have high expectations, there's no way you're going to have physical activity improvement. But what we're missing are the steps to (get there)."

If doctors know their patients want to be more physically active after surgery, they can refer them to rehabilitation or community-based exercise programs, Jones added.

Joint pain and function not always better after surgery---50% success at best!
By Genevra Pittman
NEW YORK | Wed Mar 27, 2013 3:43pm EDT
(Reuters Health) - Only about half of people who have a knee or hip replaced see meaningful improvements in pain and disability in the months after surgery, a new study from Canada suggests.

Researchers found people who had worse knee or hip pain to begin with, fewer general health problems and no arthritis outside of the replaced joint were more likely to report benefits.

"I think this study really represents the general picture that often people do not have arthritis in just one joint," said Elena Losina, an orthopedic surgery and arthritis researcher from Brigham and Women's Hospital in Boston.

"It's of course good to set expectations appropriately that if you have three joints affected, doing one procedure is not going to be a miracle," said Losina, who co-wrote a commentary published with the new study.

More than one million people in the U.S. have a knee or hip replaced each year, researchers said - a rate that's expected to continue to grow.

Including hospital fees and the parts themselves, the procedures cost $20,000 to $25,000 and are typically covered by insurance.

Despite the rising popularity of joint replacement, uncertainty remains about which patients have the most to gain and who fares best post-surgery. So a team led by Dr. Gillian Hawker from the University of Toronto tracked about 2,400 older adults with osteoarthritis or inflammatory arthritis in Ontario, Canada, to see who went on to get surgery and how they did.

From the start of the study in 1996 through early 2011, 479 of them had a knee or hip replaced, including 202 who underwent elective surgery and had before and after pain and disability information available for analysis.

Most surgery patients were women with pain in more than one joint, and over 80 percent were overweight or obese.

By a year or two after surgery, the average person had a 10-point improvement in pain and disability from a pre-surgery score of 46.5 out of 100, the research team wrote in Arthritis and Rheumatism.

A nine-point improvement is considered the "minimal important difference" in symptoms, and about 54 percent of joint-replacement patients hit that target.

Unlike general health and other joint problems, people's weight did not predict how they did after a knee or hip replacement, Hawker and her colleagues found.

Losina said that even if a first joint replacement leaves people with some pain and disability, it may help them make incremental steps toward better health.

And doctors may need to realize that until some people get each of their painful joints replaced - not just one knee or hip - they're not going to have optimal outcomes, according to Hawker.

"We have to look at the whole patient, not just a single joint," she told Reuters Health.

Researchers said the new findings provide more evidence for patients and their doctors to use while discussing the pros and cons of knee and hip replacement.

"This is not an easy surgery, it's an expensive surgery, and I think people should understand what they are getting into and what are the expected outcomes," Losina told Reuters Health.

Andrew Judge, who has studied joint replacement outcomes at the University of Oxford in the UK, agreed these kinds of findings are important to help inform doctor-patient decision making.

"Further research is required in other large datasets in order to confirm these findings, and to identify other key determinants of good outcomes, to inform the development of a future clinical risk prediction tool," he told Reuters Health in an email.

Ed Note: But no matter what all the above experts say, in 2013 another half million suckers will fall for their doctor’s advice and suffer (and we do mean SUFFER) the consequences! How do we know that?  Because after a year (or two or three or more) of pain, many of them come to us for help.

J&J reaches $4 billion deal on hip implant lawsuits: report
Gee, isn’t it wonderful?  This bunch of patient-slaughtering profiteers will be forced to pay $100,000 or so to thousands of people whose lives they destroyed.  They sold this crap system LONG after they knew how bad it was.  But profits are profits and patients are lab rats---and always will be.

(Reuters) – November 2013--- Johnson & Johnson will pay more than $4 billion to settle thousands of lawsuits over its recalled defective hip implants, Bloomberg reported late on Tuesday, citing three people familiar with the deal.
Johnson & Johnson declined to comment on the report.

The deal will resolve more than 7,500 lawsuits brought against J&J's DePuy orthopedics unit in federal and state courts by patients who have already had the defective devices removed, the report said.

De Puy recalled thousands of its metal ASR hip systems due to higher-than-expected failure rates. Plaintiffs claim that defective metal-on-metal devices caused pain, discomfort and more serious complications, including increased levels of metal ions in the bloodstream.

The devices were introduced in the United States in 2005, and DePuy recalled the product in 2010 after selling an estimated 93,000 units worldwide. Data from the UK at the time showed that about 12 percent of the implants needed to be replaced after five years.

Metal implants were developed to be more durable than traditional hip implants, which combine a ceramic or metal ball with a plastic socket. All-metal implants can shed metallic debris, potentially damaging bone and soft tissue, according to the U.S. Food and Drug Administration.

Have the Profiteer MDs stopped Cheating you in 2014? Ask Reuters:
One-third of knee replacements in the U.S. may be inappropriate
(Reuters Health) - Judging by the symptoms of people with knee arthritis, one-third of knee replacement surgeries may be inappropriate, according to a new study.

“We found that some patients undergo total knee replacement when they have very low grade symptoms or minor knee arthritis,” lead author Daniel L. Riddle from Virginia Commonwealth University in Richmond told Reuters Health in an email.

The number of total knee replacement surgeries done each year more than doubled between 1991 and 2010, leading some to question whether the procedure is overused. This is hard to prove, though, since symptoms like pain tend to drive the decision to proceed to surgery, and different people perceive pain differently.

To get a better idea of what is going on, Riddle and his team analyzed data from a study of about 4,800 people in the U.S. with knee osteoarthritis or at high risk of the condition. During the study period, 205 of them had total knee replacement surgery.

The researchers used criteria for knee replacements developed by Dr. Antonio Escobar of Hospital de Basurto in Vizcaya, Spain and his colleagues. Surgeries were judged to be appropriate, inappropriate or inconclusive considering factors like a person’s range of motion, pain and arthritis severity.

Based on prior studies, the researchers expected to find that about 20 percent of surgeries were inappropriate. What they found, though, was that about 34 percent of patients had total knee replacements that were deemed to be inappropriate.

For the most part, these patients had symptoms that were moderate at worst and joint damage that was not widespread.

Less than half of knee replacements - 44 percent - were classified as appropriate, according to findings published in Arthritis & Rheumatology. That left about 22 percent in the inconclusive category, which included patients with severe symptoms who were either younger than 55 years old or had less joint damage and normal mobility.

Does this mean U.S. surgeons are performing too many knee replacements on patients who don’t need them? Not necessarily. For one thing, Riddle said, “the scientific content and the standard at the time (this system) was developed is clearly different from that in the U.S. in 2014.”

Doctors and patients need to do a better job deciding when it’s the right time for a knee replacement, if ever, he added.

“I would encourage patients to gather and share information with their family physician and surgeon to determine if they are good candidates for the procedure,” Riddle said.

“The key issues, in addition to a reasonably healthy medical status, are the extent of pain, extent of compromised function and extent of knee osteoarthritis,” Riddle explained. “We have very good prognostic data now and we know that persons with high levels of psychological distress, minor knee osteoarthritis, serious (other health conditions) and multiple joint arthritic disease are at greatest risk of poor outcome.”

The authors say that research should now focus on developing a system to separate inappropriate from appropriate knee replacements that is based around U.S. patients.

SOURCE: bit.ly/1vp5ukD Arthritis & Rheumatology, online June 30, 2014.

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