Around 700,000 people in the U.S. undergo knee surgery each year. But a new study finds no significant difference in improvement between patients who had one common knee surgery — arthroscopy — and those who underwent a fake surgery. We’ll discuss the effectiveness of knee surgery and how to keep your knees healthy.

Dr. Jeffrey Halbrecht, medical director of The Institute for Arthroscopy and Sports Medicine in San Francisco; and former medical director for the Women's Pro Ski Tour
Dr. Kevin Bozic, William R. Murray Professor and vice chair of the UCSF Department of Orthopedic Surgery
Dr. Moshe Lewis, physical medicine and rehabilitation physician at the California Pacific Medical Center

  • $22911251

    In 1982 I tore the meniscus telemark skiing in southern Colorado. I lived in a small mountain town and initially was evaluated by a generalist. I followed the instructions for intensive anti-inflammatory treatment with hours of icing. After a month the knee still felt unstable so I headed to Vail to see a knee specialist. He evaluated the tear as a 8 on a scale of 10 and recommended physical therapy. I jumped on the bike and in the pool, and within a two months was back telemarking, I have never had pain in my knee since. Is it possible that the Vail orthopedic doctors relied on physical therapy because they recognized athletes would do the work to stabilize the injury?

  • Ginny Bahr

    What are the doctors’ opinion on cadaver tendon vs patient tendon for ACL repairs. I had cadaver tendon(s) plural used for my left ACL by a reknowned Aspen, CO surgeon and feel it’s never been quite right.

  • Janet Cook

    Surgery is important to have if necessary. But why doesn’t anyone talk about the need of Western culture to change it’s posture to align bones with gravity like cultures who do not have these kinds of problems do? No surgery required!

    • Vicky Chang

      that is very un-specific.

  • Steve S

    What is the doctors’ opinions about microfracture surgery for a physically active male in his mid-50s? I tore my meniscus and the MRI discovered cartilage erosion in the joint. I was having pain from the meniscus but not from the cartilage issue. I had the surgery and it was very difficult to recover from, and continues to ache periodically. The meniscus is fine.

  • Vicky Chang

    I believe the seated straight leg raise is the single most important exercise. Sitting in a chair, straighten one leg, flexing the toes towards the head, raise the leg slowly activating the quad muscles, lower slowly and repeat some number of times. Repeat with the other leg. By locking the leg straight the knee joint rests while the muscles supporting the kneecap get the workout. I have osteo-arthritis with 70% bone-on-bone and I still walk more than one hour per day. Any comments on the aging population and disappearing knee cartilage?

  • 2yrs ago I suffered an acute medial meniscus tear and was told to get surgery. I refused and did acupuncture and tuina instead. Within 4 months I was back to full activity. The other keys were that I kept active despite the injury and increased my rom. I am in my 40’s so it is possible as long as one is proactive and works within their limits.

  • 1PeterDuMont2STARALLIANCE8

    A note of appreciation for surgeons…and also the safety net that many participate in.

    At age 39 I did an athletic move after gradual meniscus wear I was largely unaware of. Raising my body without hands from a cross-legged sitting position with a video camera on my shoulder, I got the video shot I wanted, alright, and also broke the meniscus in my right knee!

    A loose piece of broken cartilage popped into the tight-fitting space between the bones of the knee and Ouch! — the whole joint locked up and became very painful as well…but I had no idea what had caused this sudden incapacitation!

    It was a weekend and I will never forget that first night, before I got diagnosed and treated. More than a bit delirious, at one point I realized what seems obvious when you’re not in pain: Wait a second! There are doctors who will know what’s going on — and probably be able to fix it! That reassuring thought got me through the night.

    On Monday I got diagnosed at UCSF and scheduled for charity surgery with Dr. Skinner a few days later. Of course he did a great job, and I’ve had a liveable knee ever since.

    Thank you, thank you, thank you!

  • trite

    is it a good idea to wear brace /bandage on knee when running?

  • trite

    Too bad you did not allow the physical therapist to talk longer. She was potentially really helpful. Perhaps you should have someone back who specializes in therapy for half-an-hour in future.

  • Vicky Chang

    It is interesting doing a show about how surgery is not good with a guests who are surgeons and make their living doing or some would say selling surgeries. The specialization of surgeons hampers any discussion of exercise and alternatives besides surgery.

  • Dr Halbrecht

    Dear Ginny: In response to your question about cadaver grafts for ACL surgery. These can be an excellent choice for some patients, but unfortunately do not seem to hold up as well in younger athletes.

  • Dr Halbrecht

    Dear Steve S:
    Microfracture surgery ia a technique that drills into the bone to try to encourage the body to heal itself when the cartilage surface of the knee has been chipped away. Unfortunately, this procedure only works approximately 75% of the time. If it has no been successful, there are other ways of “resurfacing” the cartilage using various types of cartilage grafts.

  • Dr Halbrecht

    Dear Trite:
    Using a brace for running or other sports can help keep the knee warm, and give a sense of confidence and support. However, most knee braces will not be able to lower the impact effect of running. There is one type of brace, called an unloader brace, that does attempt to shift the weightbearing effect by shifting the weight from one side of the knee to the other. This type of brace can be useful for someone who has arthritis on only one side of the knee.

  • Dr Halbrecht

    Dear Vicky:
    The straight leg exercise is a terrific choice! This is a way to strengthen the muscles around the knee without directly loading the joint.

  • Dr Halbrecht

    Dear Peter:
    Your experience is the typical one to expect when one suffers an acute (sudden) tear of a meniscus. You chose an excellent doctor and so happy to hear that you had a great result. These acute meniscus tears are very different than the ones discussed in the recent study published in the New England Journal of Medicine.

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