Knee Surgery and the Iatrogenic Problem

I recently happened to be thinking of what it takes to beat knee pain, and things that often don't work.

Surgery came to mind.

Now, to be clear right from the outset: Surgery may be a good idea for you. In fact, it may be a great idea. It all depends on what's causing your knee pain, and whether a surgical solution fixes that.

What worries me: I think there are too many people in the situation I was once in, when I had chronic, diffuse knee pain that had no clear cause. After a while, their thinking goes like this:

I've tried everything they've told me to do. I don't seem to be getting better. I have nowhere else to turn. Should I have surgery?

Surgery as a last resort, when the doctor plans to look around your knee and "clean up" some areas of damage, seems like a potentially risky proposition.

This isn't like someone popping the hood on your car, spotting a loose battery cable, then tightening it down and then -- voila! -- the car works great again.

I suppose a surgeon can look for loose bodies and remove them. Fine. But when it comes to trimming and shaving the existing cartilage, how does a surgeon know exactly how much cartilage to remove? This knee joint you'll be using thousands of times a day, probably, and a screwup could leave you in even worse shape.

Which brings me to the word of the day: iatrogenic. It's an interesting word that I was unaware of before I began my knee pain journey. It refers to new injuries that are created by surgical intervention.

That's a sobering thought. You go under the knife to get better. What you may not realize: there's a not insignificant chance you'll emerge worse off.

I do think most surgeons are pretty good, and they certainly have your best interests in mind. But what they do is very, very hard, and they're not trying to fix a machine, but a human being. That's a task of a much higher order.

Again: I'm not trying to imply that surgery is never a good idea. It sometimes is. But before you commit, you should have a good idea of what the surgery is trying to do and what the chances of success are.