Knee replacements may not be as reliable as previously thought

Evidence for the efficacy of knee replacement surgery is shakier than ever. New research from experts at Oxford University reveals that there is insufficient long-term data demonstrating the efficacy and reliability of knee replacements. This comes at a time when the number of middle-aged people undergoing knee replacement surgery has increased dramatically in the past decade.

Researchers of the new study reviewed data from several national registries. Since this data primarily consists of statistics on the number of surgeries and redo surgeries, the researchers pointed out that there is no significant data on patients long-term satisfaction with knee replacements, or information on whether patients continued to experience pain and disability. They also discovered that many patients who received surgery may not have needed in the first place since they were young or only exhibited mild symptoms.

Currently, there are dozens of knee replacement designs on the market. When problems arise with a specific design, physicians typically cease using the model and the company may pull it from the market. However, researchers pointed out that doctors often assume that newer designs will automatically be better despite that there is insufficient data on the products. Unlike medicine, joint replacements do not need to undergo the same process of research and regulation before entering the market.

In addition to making recommendations on ways to improve research and regulation of knee replacements, researchers concluded that there needs to be “better management of young people with early arthritis” to avoid the need for surgery.

If you’re under the age of 55 with knee osteoarthritis, early conservative treatment could help you avoid the potential risks and costs of joint replacement surgery. In addition to weight loss and exercise, chiropractic care can improve joint functioning and relieve knee pain from osteoarthritis.

References

“Knee Replacements Up Dramatically Among Adults 45 to 64 Years Old.” Agency for Health Care Research and Quality. November 3, 2011. Accessed January 2, 2012. //www.ahrq.gov/news/nn/nn110311.htm .

Carr A, Robertsson O, Graves S, et al. Knee replacement. The Lancet 2012; DOI: 10.1016/S0140-6736(11)60752-6.

Gever, John. “Knee Replacement Outcome Data Fall Short.” Medpage Today. March 5, 2012. //www.medpagetoday.com/Orthopedics/Orthopedics/31500. Accessed March 13,2012.

Weight Loss Reduces Knee Pain

Excessive weight is hard on all of the joints in the body and weight loss is known to reduce chronic back pain issues. The knees, however, are of particular concern with excessive weight. A recent study explored the effects of massive weight loss via gastric bypass on chronic knee pain.

The study objective was to explore how massive weight loss would affect knee pain and disability, low-grade inflammation and metabolic status and joint biomarkers. The study included 140 gastric bypass patients with knee osteoarthritis. Prior to surgery, various tests were done to evaluate degree of knee pain and disability, overall health and various joint biomarkers such as cartilage turnover.

Insulin and insulin resistance decreased at 6 months following the surgery as well as knee pain and disability. Cartilage turnover improved as well with an increase in markers that indicate cartilage synthesis and a decrease in markers that indicate the break-down of cartilage.

Researchers concluded that massive weight loss is capable of decreasing pain, improving function and decreasing inflammation. The weight loss may have a structural effect on cartilage given the joint biomarker findings in the study.

Chiropractic treatment plans include measures that will help improve health as well as decrease any obstacles to better health, less pain and better quality of life. Weight loss and nutritional supplements are just one of the many issues your chiropractor can help you address.

Reference

Richette P, Poitou C, Garnero P, Vicaut E, Bouillot JL, Lacorte JM, Basdevant A, Clement K, Bardin T, chevalier X. Benefits of massive weight loss on symptoms, systemic inflammation and cartilage turnover in obese patients with knee osteoarthritis. Annals of the Rheumatic Disease. 2011 Jan;70(1):139-44.

Non-surgical Treatment for Osteoarthritic Knee Pain

As we age, our knees begin to show signs of wear and tear, and studies show that an increasing number of middle-aged people are seeking total knee-replacement surgery. While there have been improvements in the surgical techniques, the procedure is still invasive and costly. Fortunately, early conservative treatment may allow patients to avoid the potential risks of joint-replacement surgery.

Research suggests that chiropractic adjustments can benefit patients with knee pain from osteoarthritis. In one study, patients who received chiropractic knee adjustments reported significant drops in pain intensity and less clicking and grinding sensations. They were also better able to perform daily tasks with enhanced mobility. The chiropractic patients also reported no adverse side effects. Patients who did not receive chiropractic adjustments in the study did not experience the same benefits.

Chiropractors can assist osteoarthritic patients in restoring normal joint alignment and gait, reducing inflammation, and finding the appropriate activities to promote flexibility and mobility. If you have chronic knee pain as result of osteoarthritis, contact a chiropractor learn more about non-surgical methods to slow down joint degeneration and reduce pain.

References

“Knee Replacements Up Dramatically Among Adults 45 to 64 Years Old.” Agency for Health Care Research and Quality. November 3, 2011. Accessed January 2, 2012. //www.ahrq.gov/news/nn/nn110311.htm.

Pollard H, Ward G, Hoskins W, and Hardy K. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of the Canadian Chiropractic Association 2008; 52(4):229-42.

 

Walker, Emily. “AHRQ: Big Jump in Knee Replacement Surgery.” November 8, 2011. Accessed January 2, 2011.//www.medpagetoday.com/Orthopedics/Orthopedics/29529.

Yoga Alleviates Knee Pain

A recent study set out to determine whether yoga therapy can help alleviate pain in patients undergoing total knee-replacement surgery.

The study involved 51 patients undergoing total knee replacement (TKR) because of osteoarthritis. On the third day after surgery, baseline scores for pain and stiffness were taken. Half of the patients received conventional physiotherapy. The other half also received once-daily yoga asana treatment. Upon being discharged from the hospital, these patients were provided with photographs of the asanas and written instructions, and instructed to perform the movements 3 days per week.1

Yoga asanas are functional postures involving slow stretching and movements of muscles and joints, and encourage different muscle groups to achieve stability and equilibrium. The purpose of the study was to determine whether yoga asanas have an added advantage for treating patients who have undergone total knee replacement.

Patients were evaluated at 6 weeks and 3 months after surgery to measure their perception of pain, stiffness, and function. The researchers found lower pain and stiffness reported by the group receiving yoga therapy than for patients receiving conventional therapy alone. They concluded that patients practicing yoga had better pain relief, reduced stiffness, and better function, suggesting that yoga asanas may be a valuable addition to conventional post-surgery treatments.

Previous studies have recommended additional non-surgical approaches to reducing knee pain, particularly that resulting from osteoarthritis. Chiropractic adjustments have been shown to benefit patients with knee pain, who reported substantial drops in pain intensity and improvements in mobility, along with fewer clicking or grinding sensations within the knee.2 Weight loss has also been shown to alleviate chronic knee pain in obese patients.3 Consult with your doctor about relieving knee pain naturally.

References

  1. Bedekar N, Prabhu A, et al. Comparative study of conventional therapy and additional yogasanas for knee rehabilitation after total knee arthroplasty. International Journal of Yoga 2012; 5(2): 118-122.
  2. Pollard H, Ward G, Hoskins W, and Hardy K. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. The Journal of the Canadian Chiropractic Association 2008; 52(4):229-42.
  3. Richette P, Poitou C, Garnero P, Vicaut E, Bouillot JL, Lacorte JM, Basdevant A, Clement K, Bardin T, Chevalier X. Benefits of massive weight loss on symptoms, systemic inflammation and cartilage turnover in obese patients with knee osteoarthritis. Annals of the Rheumatic Disease 2011;70(1):139-44.

Young Patients at Risk for Complications After Knee Surgery

Many doctors refer young, healthy patients for bilateral knee replacement under the assumption that their overall health and youth will protect them from complications. A new study suggests that may not always be the case.

Beginning in the 1990s, researchers noticed a trend in more young, healthy patients getting bilateral knee replacement surgery. Their recent study seeks to determine what these trends mean in terms of postoperative complications. The researchers found that youth did not protect patients from the problems associated with knee surgery.

They suggest that the introduction of a systematic selection process may be able to improve outcomes. New guidelines for selecting bilateral knee replacement patients will be published shortly, and it is hoped that they may help physicians appropriately select patients.

If a patient is not considered to be a good candidate for bilateral knee replacement, this will be discussed with the patient. Also, non-surgical alternatives will be discussed. For example, chiropractic care has been shown to be effective at treating knee pain. Chiropractic treatments do not carry the potential complications of surgery, and may be safely used on patients of all ages, and on many patients who are not medically-able to undergo knee replacement surgery.

Reference

Memtsoudis SG, Mantilla CB, et al. Have Bilateral Total Knee Arthroplasties Become Safer?: A Population-Based Trend Analysis. Clinical Orthopaedics and Related Research 2012;doi: 10.1007/s11999-012-2608-9.

Youth and Health No Safety Guarantee in Bilateral Knee Replacement. Musculoskeletal Network. October 1, 2012. Accessed October 15, 2012. //www.musculoskeletalnetwork.com/orthopedic-surgery/content/article/1145622/2105499?GUID=1872F93E-A23F-4C03-A5A8-1182754076E4&rememberme=1&ts=09102012.

Got Knee Pain? Try Pressing Your Body’s Meridians

Osteoarthritis (OA) is the most common joint disease, commonly affecting the knee joint. Painful knee OA affects up to 10% of adults over the age of 55. Various medications have been used to treat knee OA pain, though these frequently have adverse effects. If the pain cannot be controlled, joint replacement surgery is often performed. In order to avoid medications or surgery, many patients seek alternative treatments to control the chronic pain of knee OA. Natural treatments such as exercise therapy, weight loss, and chiropractic care are often used to treat knee OA.

Collateral meridian (CM) therapy, a form of acupuncture/acupressure, is another alternative natural treatment that may be considered for chronic pain management. This recently-developed technique, a variation of traditional Chinese acupuncture, follows traditional Chinese medicine principles. CM involves manipulating a distant nonpainful collateral meridian in order to facilitate pain dissipation. It has already been shown to be effective in pain management, though no studies have focused on the use of CM therapy for knee OA.

Recently, a team of researchers conducted a pilot study to determine whether CM may be effective at treating knee OA pain. The study involved 28 patients with knee OA. Half received a placebo treatment, while half received CM therapy twice weekly for three weeks. Before and after treatment, pain intensity and knee function were measured.

In the CM group, the post-treatment measurements of pain intensity and knee function had improved, while no comparable change was seen in the placebo group. The study showed that collateral meridian therapy may be effective for relieving knee OA pain, though more research is needed to confirm this benefit.

Reference

Horng, H, et al. The effects of collateral meridian therapy for knee osteoarthritis pain management: A pilot study. Journal of Manipulative and Physiological Therapeutics 2013; 36 (1): 51-56.

Exercise As Good As Surgery for Knee Pain

Considering knee surgery? You may not want to rush into the operation room, a new study suggests.  The study shows that physical therapy and exercise are as effective as surgery for knee arthritis and torn cartilages.

The researchers recommended that patients try physical therapy before surgery, since exercise carries less costs and risks.

Every year nearly half a million surgeries are conducted for torn meniscus. A meniscus is C-shaped cartilage in the knee which helps distribute the body’s weight evenly across the joint. Although tears to the meniscus don’t always causes symptoms, it can produce significant pain.

People with arthritis are more likely to have a torn meniscus, making it difficult to distinguish whether knee pain is the result of arthritis or a tear. This also means it’s challenging to know when surgery will help.

To see whether some patients could avoid knee surgery, researchers compared surgery with physician therapy in a group of 351 patients with arthritis and meniscal tears. Patients assigned to physical therapy were given the option to crossover to surgery. While some PT patients did opt for surgery later on, those who stuck it out with therapy for six months to a year had the same improvements as people who had surgery.

The findings confirm that patients with knee pain can avoid the adverse effects of surgery by pursuing conservative options first. Research suggests that chiropractic care, combined with exercise and weight loss, is another effective way to relieve knee pain naturally.

Reference

Katz, et al. Surgery versus physical therapy for meniscal tear and osteoarthritis. The New England Journal of Medicine 2013; doi: 10.1056/NEJMoa1301408.

Sciatica

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Sports Injuries

Sports injuries and chiropracticChiropractic is an integral part of the care that many professional athletes receive. Many Olympic athletes also take advantage of the benefits of chiropractic. Just because you aren’t going to the Olympics doesn’t mean that you too can’t improve your health and performance with chiropractic care.

When it comes to sports injuries, weakness or improper stretching can put you at risk of injury. In addition, an untreated injury may result in further or even permanent damage. It is vitally important to get proper care for any sports injuries, preventing the development of chronic problems.

There are two basic types of sports injuries: the first is the result of a trauma inflicted by a collision, a slip or a fall. The second type is caused by the over-use of a muscle group or joint whereby the repetitive movement of the same area causes an inflammation or injury.

As chiropractors, we’re trained in treating sports injuries, we can advise you in the best way to heal an injury and how best to prevent it from recurring. Treatment can range from massage therapy to joint manipulation, or specific exercises that target problem areas and strengthen previously injured or weakened muscles and joints.

Any sporting activity should be preceded with a warm-up session. It is best to increase the frequency or duration of workouts slowly and progressively as strength and fitness levels increase. Fatigue or stress can be risky when working out, as it puts you at a higher risk of injury.

Working in conjunction with a qualified trainer and a chiropractor can help you stay in great shape and prevent injuries.

If you’ve suffered a sports injury, give our office a call.

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Hip and Joint Pain

Whether you’re suffering from arthritis or repetitive stress injuries, joint pain can severely limit your quality of life. A chiropractor can use a combination of extremity adjustments and exercise therapy to improve your range of motion and reduce pain.
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