When people hear the term “orthopedic,” it’s only natural to add “surgeon” afterward. Yet, there are many common joint injuries and conditions that don’t necessarily require surgery. While it’s essential to visit an orthopedics specialist in order to get an accurate diagnosis and recommendation for treatment, that doesn’t always mean that treatment is going to be surgical. Here’s a look at some common injuries and conditions that are typically treated non-surgically.
- Meniscus Tear: A surgical approach for torn meniscus repair in an arthritic knee isn’t always necessary unless there are significant mechanical symptoms in that knee such as severe catching and/or locking. Without catching or locking, the torn meniscus is considered part of the degenerative process of arthritis, which can be treated non-surgically.
- Rotator Cuff Tear: Another example of a commonly non-surgical diagnosis is a rotator cuff tear. The rotator cuff is a group of tendons at the top of the shoulder joint that help rotate and elevate the shoulder during daily usage. Tears—especially partial tears—rarely if ever require surgical treatment.
- Medial Collateral Ligament Tear: In the knee there is a ligament on the inside, or medial side, that some years ago was thought to necessitate surgery when the tear was complete. These days, nonsurgical treatment is recommended for almost all MCL tears, even complete ones. When braced, these ligaments tend to heal on their own and can be as strong (or nearly as strong) as they ever were without surgery. This is a very good example of the evolution of the orthopedic and sports medicine approach to injuries.
And of course, there are many other instances of ligament injuries, tendon injuries and tears in and about most of the joints that do not necessarily require surgery.
Surgery Helps in the Right Situation
None of this is to say that surgery is necessarily a bad idea or an improper treatment recommendation. For example, early surgical treatment of rotator cuff tears can be good idea if the tendon is pulled further and further away from its original attachment and may become inoperable. When that happens, the treatment revolves around relieving pain and not necessarily restoring maximum function.
And surgery may still be the right first step for some injuries. A complete ACL tear is rarely treated non-surgically in an athletic patient. This ligament is responsible for rotational stability of the knee, which doesn’t swing straight open and shut like a door hinge, but instead has a slight rotation. A tear in this ligament causes instability during many sports and sports-like activities that involve acceleration, deceleration, and changing direction quickly, because it no longer holds the knee in a good position as it extends. Surgery can be essential to restore full function in athletes.
Factors to Consider
Making the choice of which treatment to select depends on more than just the injury itself, however. The patient’s age and lifestyle are also determining factors in deciding how to proceed with treatment. For example, an ACL tear in an older arthritic patient may be due to normal degeneration associated with age and arthritis, both of which are much better addressed non-surgically. An attempted ligament reconstruction could lead to stiffness or other problems beyond what would have occurred with the complete absence of that ligament.
While there are definitely some conditions and emergency situations that do require surgical treatment, patients shouldn’t feel concerned that surgery is their only option. The best treatment is the one that promotes recovery for individual patients in the best way possible according to his or her needs, hopes and diagnosis.