The common arthritis surgery that’s a borderline scam

To replace or not to replace…

That is the question for thousands of arthritis patients who suffer from chronic knee pain.

The idea of having a knee replaced may sound daunting. But these days, total knee replacement can be done on an outpatient basis.

So now the question is… Inpatient or outpatient?

The decision might seem simple. After all, who wants to stay in the hospital when they don’t have to? However, it may be in your best interest to not head straight home. The fact is, there are several hidden knee-replacement risks your doctor might not even know about.

The inpatient/outpatient dilemma

Total knee replacement — also known as total knee arthroplasty, or TKA — is a big business, and it’s expected to explode over the next 20 years.

This upswing is due in part to the convenience of newer outpatient TKA. But while the convenience might be tempting, it has to be balanced against potential dangers, as researchers at UCLA recently discovered.

Accessing records from an insurance database, the UCLA team compared the outcome of 4,400 patients who had outpatient TKA with 129,000 individuals who stayed in the hospital for at least one day post-surgery. On average, majority of the patients were in their early 70s.

While rates of post-surgical complications between the two groups weren’t extremely different, the outpatient group did experience more of the following:

  • Infections
  • Deep vein thrombosis (potentially life-threatening blood clots in the leg)
  • Knee pain
  • Stiffness that required joint manipulation under anesthesia
  • Repeat surgery
  • Removal of knee replacement prosthesis

In a press release that coincided with the study’s publication in The Journal of Bone & Joint Surgery, the researchers emphasized that doctors and patients should consider “adequate access to important rehabilitation at home during the important early postoperative period.”

In other words, you might be out of the hospital and home the same day, but close monitoring is essential to avoid dangerous complications.

High likelihood of a second surgery

There’s one other way you can avoid TKA complications: Skip the surgery altogether.

This is a vital consideration in the view of Dr. Marc Micozzi, who happens to suffer from knee osteoarthritis himself.

In an overview of this topic in his Arthritis Relief and Reversal Protocol, Dr. Micozzi notes that there are two types of TKA: primary and revision. And it’s the latter one you’re not likely to find out about until it’s much too late.

Dr. Micozzi explains: “Primary is your FIRST replacement. A revision occurs when a primary fails or wears out. This ‘replacing the replacement’ surgery is now much more common. Why? Because MOST primary knee replacement procedures are inappropriate and/or ineffective. They are being done before they’re really needed, and at an increasingly young (and inappropriate) age.”

To illustrate, Dr. Micozzi cites a few statistics…

  • The Journal of the American Medical Association (JAMA) reports that between 1991 and 2010, TKA in Americans over age 65 skyrocketed 162 percent
  • In 2010, doctors replaced nearly 244,000 knees at an average cost of $15,000 per knee
  • The JAMA study predicts 3.5 million knee replacements per year by 2030
  • Nearly five million Americans have already had the surgery

This treatment is simply unwarranted, as evidenced by another study Dr. Micozzi cites: “Two doctors and a physical therapist at Virginia Commonwealth University in Richmond analyzed the records of 205 patients with knee osteoarthritis, all of whom had undergone total knee replacement surgery.

“They found that only 44 percent of the surgeries were ‘appropriate.’ Another 34 percent were blatantly ‘inappropriate.’ And 22 percent were ‘inconclusive.’ Most of the inappropriate group had only slight to moderate symptoms, and tended to be under 55.”

Dangers on top of dangers

As if the fact that less than half of TKA surgeries are warranted isn’t bad enough — brace yourself — this situation gets worse…

Dr. Micozzi notes that there’s also an issue of poor outcomes from operations performed by surgeons who do fewer than 12 TKA surgeries per year. And according to a study in the journal Arthritis & Rheumatism, the same problem is found when hospitals with a high-volume of TKAs (more than 200 per year) are compared to hospitals with low-volume.

The study revealed that low-volume hospitals had up to three times as many post-TKA blood clots and twice as many deaths!

And to put a cap on all this, Dr. Micozzi offers one more note of caution: “A new study in the journal Arthritis and Rheumatology shows that people who have total knee or hip replacement have a 5 percent greater risk of a heart attack than people who don’t have the surgery.”

The study showed that the heart attack risk lessened over time, but the risk of blood clots remained high for years. When these clots form in your legs, they can travel to your lungs and trigger a fatal pulmonary embolism — the leading cause of sudden death.

Looking at the convergence of all these issues, Dr. Micozzi estimates that at least two-thirds of the people considering or being encouraged by doctors to get TKA should not rush into surgery.

But that doesn’t mean you have to resort to powerful drugs, addictive pain killers, or agonize at the thought of toughing it out. Instead, first explore non-surgical and non-drug treatments to treat your joint pain or arthritis. A wide variety of treatment strategies are featured in Dr. Micozzi’s Arthritis Relief and Reversal Protocol. To learn more or enroll today, click here.


Outpatient total knee replacement surgery linked to higher rates of complications
December 14, 2018