Does Scoping Knees Help Arthritis?

Arthroscopic knee surgery for people suffering from osteoarthritis is a popular treatment but according to a new study published in the New England Journal of Medicine, knee arthroscopy doesn’t actually reduce joint symptoms or improve function when compared with nonsurgical treatment.

Canadian researchers examined the effectiveness of arthroscopic surgery, the process of making small surgical incisions and inserting a thin, flexible fiber-optic scope and other small instruments into the knee joint to remove pieces of cartilage and smooth the joint surfaces. Arthroscopy is used to repair osteoarthritis as well as other knee problems.

The study treated 178 patients with moderate to severe osteoarthritis of the knee and an average age of 60 years old.  All patients recieved physical therapy and medications such as ibuprofen or acetaminophen but 86 of the patients also received arthroscopic surgery. They were then tracked for two years.

The researchers found that both groups of patients experienced similar improvements in joint pain, stiffness, and function.  At the end of two years, the researchers concluded that compared with nonsurgical treatment, arthroscopic surgery of the knee did not improve joint symptoms or function for people suffering from osteoarthritis of the knee.

It is important to note that the study focused on arthritis-related knee problems — arthroscopic knee surgery is still beneficial in other conditions that affect the knee, such as meniscal and ligament problems.

Patients who have a combination of knee problems, such as osteoarthritis and a meniscal tear might also respond better to arthroscopy.

Source: Kirkley, A. The New England Journal of Medicine, Sept. 11, 2008; vol 359: pp 1097-1107.


Chiropractic in Brazil is in Trouble

I love physical therapy as a profession…I really do.  I don’t have the time or interest in walking patients through long rehabilitation procedures or exercises.  I do not enjoy working with stroke patients and teaching them how to walk again.  Not my area of expertise or specialty.  I’m thrilled there are people willing to do those things and who excel at them.  I am friends with some of them and have good, respectful, working relationships with others.

That being said, this situation that is happening in South America is getting my goat.  It seems in a new threat to the independence of chiropractic, physical therapists in Brazil, Peru and other countries in South America are lobbying governments for laws that would make chiropractic a sub-specialty and part of the physical therapy profession.

Since chiropractic is not yet licensed in those countries, the PTs feel that by acting quickly, they can absorb a profession that is more than simply spinal manipulation, and make it their own.  The Brazilian Chiropractors’ Association (ABQ) has been campaigning to establish the chiropractic profession but their 200 members are going to have a difficult time against the 95,000 PTs already in Brazil alone.

Chiropractic has been growing rapidly in Brazil since the opening of two university-based chiropractic colleges in the late 1990s – Feevale Central University in Novo Hamburgo, in partnership with Palmer College; and the University of Anhembi Morumbi in Sao Paulo, in partnership with Western States Chiropractic College. The legislation to protect chiropractic and being promoted by the ABQ was approved by a third and final parliamentary Commission in late November 2006 and must now go back to the full house or Camara for final vote. It is being stalled by legislators working with the PT profession, while PTs are providing short courses in chiropractic to try to create a competing chiropractic profession.

Advertisement claiming chiropractic is a specialty of physical therapy, and placed in Brazil’s national newspaper The Globe in February by Brazilian physical therapists.

Advertisement claiming chiropractic is a specialty of physical therapy, and placed in Brazil’s national newspaper The Globe in February by Brazilian physical therapists.

 Recently, the fight for chiropractic in Brazil took a turn when the Federal Police, acting upon a complaint from physiotherapy leaders, challenged visiting doctors of chiropractic for being engaged in the illegal practice of physiotherapy in southern Brazil. 

As chiropractors, what happens in other doctor’s backyards will eventually affect us. The World Federation of Chiropractic (WFC) is asking for chiropractic associations, colleges, other organizations and individuals to assist the ABQ and chiropractic in Brazil financially. We need to stop the PTs in Brazil from succeeding in their attempts to hijack this profession.

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