This may come as a surprise for many people out there, but a lot of orthopedic surgeries aren’t all that they are sliced up to be. To the medical community merely uttering these words is an act of heresy, deserving swift and severe punishment on the altar that medicine has built. To others, this news may come as a relief and even may have arrived just in time. Perhaps the thought surgery is frightening and you want to know everything you can before making a decision. That’s a solid plan!
I recently just finished up a fascinating book written by orthopedic surgeon, Ian Harris, titled Surgery, The Ultimate Placebo. Aside from the fact he wrote from a place of vast experience, he brought the evidence to the table.
“It is estimated that in 2006 there were seventy-five randomized trials published in the medical literature every day, and there are now over 20 million medical articles published, yet there have only ever been a handful of published placebo (sham) studies involving surgery.”
Here is a short list of just a few procedures that are currently under significant scrutiny:
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Meniscus removal for degenerative meniscal tears
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Shoulder labrum repair for Type II SLAP (labrum/biceps tendon tears)
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Filling vertebrae with surgical “cement” for osteoporotic compression fractures
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Open, “clean-up” surgery for tennis elbow
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Knee arthroscopy for arthritis
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Spinal Fusion (!)
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Subacromial Decompression (see below)
A recent article published in the British Journal of Sports Medicine, explored the effectiveness of decompression surgery for subacromial pain syndrome (SAPS/shoulder/rotator cuff pain). Keep in mind, this analysis came to the same conclusion as multiple papers before it.
“…….decompression surgery for SAPS provided no important benefit compared with placebo surgery or exercise therapy and is probably associated with a risk of serious harms.”
To be clear, it’s not time to throw the baby out with the bath water. Surgery has its place, especially ones that have been submitted to blinded, sham/placebo trials and proven successful. I’m not a surgeon and won’t tell you to have or not have surgery. If you think surgery is something you may need, definitely ask a surgeon. And then get a second or even third opinion. It’s my job to give you the current information available to help you avoid a needless, potentially unsuccessful surgery.
If you are experiencing joint pain, I’d like to know about it! As a chiropractor who specializes in sports medicine and rehabilitation, there’s a good chance I can help.
