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JOINT ARTHROSCOPY/ KEYHOLE SURGERY

 

 

The latest research is showing that exercise-based “pre hab” with a Physiotherapist can determine whether a specific exercise program can actually have a better outcome.

JOINT ARTHROSCOPY / KEYHOLE SURGERY  THE ANSWER?

Joint arthroscopy or keyhole surgery allows internal examination of a joint using a  small fibreoptic camera (the arthroscope).

For decades it was thought that repairing damaged joint tissue, cartilage and ligaments would fix the problem, the most up-to-date research now tells us otherwise.

Research Findings

Knee arthroscopy is one of the most commonly performed surgeries.

  • While arthroscopy is common for knee meniscus injuries it is no longer supported by any research. (Järvinen et al 2016).
  • The British Medical Journal Rapid Recommendations group makes a strong recommendation against arthroscopy for osteoarthritis as there is no lasting benefit with less than 15% of people having a small short-term benefit only (Siemieniuk 2017 ).
  • Two major trials of arthroscopic surgery for osteoarthritis of the knee found no benefit for these surgeries (Kirkley et al 2008-09, Moseley et al 2002) There are now some 20 major studies coming to the same conclusion (Bohensky 2012).
  • Many medical insurgence providers are now reluctant to cover this procedure.

Hip arthroscopy has also been popular but is now withdrawn from benefits for the same reasons. Sadly this is still widely used for conditions such as osteoarthritis, labral tears, femoroacetabular impingement and osteochondritis dissecans.(MBS see Hip Surgery items)

Modern  Management

The Australian Rheumatology Association is urging doctors to pay attention to the overwhelming research and avoid arthroscopic surgery, discussing alternatives such as exercise therapy to address the problem instead (Han E 2018)

Physiotherapists are fully trained and qualified to assess the problem of a painful joint, and provide high quality, exercise based treatment programs to assist with return to function.

DMA Clinical Pilates and Physiotherapy has trained over 10,000 physiotherapists world-wide in directional-classification and pilates-based functional restoration methods, and are leaders in Clinical Pilates rehab and Prehab treatment programs.

Article compiled by Physiotherapists from DMA Clinical Pilates and Physiotherapy, 1 Yarra Street, South Yarra 3141, ph 98274511.

DMA Clinical Pilates and Physiotherapy and affiliated Clinical Pilates Network (CPN) Physiotherapists are leaders in Clinical Pilates rehab and Prehab treatment programs

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