Orthopedic Surgery – Do You Really Need It?

Orthopedic surgeries have become increasingly common worldwide. For example, in the United States alone, the number of hip and knee replacement surgeries is expected to rise dramatically by 2040 among both men and women across all age groups – increasing by a staggering 284% for hips and 401% for knees compared to 2014.

Several factors drive this across-the-board increase. Populations in developed countries are aging, making age-related conditions like osteoarthritis more prevalent. Additionally, people in their 40s and 50s are choosing joint replacements to maintain active lifestyles – a dramatic change from behaviors of these age groups in past decades.

But is orthopedic surgery always necessary? Health systems worldwide face growing pressures from this rise in demand. For instance, in Australia, the surge in knee replacements has caused dramatically longer wait times in public hospitals. And in the UK, some patients wait up to three years for knee surgery – which is pushing many away from the public healthcare system and toward private healthcare options.

In this blog, we’ll take a deep dive into the reasons behind increasing orthopedic surgical rates, the most common types of surgery and the risks involved in them, the viability of non-surgical options and how a second opinion can potentially enhance patient outcomes.

Common Conditions Leading to Orthopedic Surgery

Orthopedic surgeries address a wide variety of conditions that affect the musculoskeletal system. Some of the most common procedures include:

Knee conditions

• Osteoarthritis – A degenerative joint disease causing pain and stiffness.
• ACL tears – Injuries to the anterior cruciate ligament, often from sports activities.
• Meniscus injuries – Tears in the knee’s cartilage, leading to pain and swelling.
• Osteoarthritis – Wear and tear of the hip joint causing discomfort.
• Fractures – Breaks often resulting from falls, especially in older adults.
• Hip dysplasia – Abnormal formation of the hip joint, potentially leading to dislocation.

Spine conditions

• Herniated discs – Discs pressing on spinal nerves, causing pain.
• Spinal stenosis – Narrowing of the spinal canal, leading to nerve compression.
• Degenerative disc disease – Breakdown of discs between vertebrae over time.

Shoulder conditions

• Rotator cuff tears – Tears in shoulder muscles or tendons, affecting movement.
• Labral tears – Injuries to the cartilage rim of the shoulder socket.
• Arthritis – Inflammation causing pain and reduced mobility.

Although orthopedic surgery can effectively relieve pain and improve mobility for many of these conditions, many of these orthopedic issues respond well to less invasive treatments, which often carry fewer risks and quicker recovery times. By clearly understanding their specific condition and available surgical and non-surgical options, patients can avoid unnecessary procedures and choose interventions that best match their personal circumstances.

The Risks of Unnecessary or Premature Orthopedic Surgery

​Any surgeries carry significant risks that can adversely affect patient health and well-being. Orthopedic surgeries are no different.

According to the National Institutes of Health, the rates of complication for orthopedic surgeries can reach over 5% – the most common being vascular injuries, nerve injuries, and periprosthetic fractures. What’s more, the effectiveness of common elective orthopedic procedures compared to non-surgical treatments is sometimes questionable. One study found that while some surgeries, such as total knee replacement and carpal tunnel decompression, provide clear benefits – others, like certain spinal and knee arthroscopies, show little advantage over non-operative care.

Beyond the physical risks, surgeries in general contribute to increased healthcare costs and resource utilization. They can also lead to psychological distress for patients, including anxiety and depression – particularly if surgical outcomes do not meet expectations.​

Given these potential risks and complications, it is crucial for patients to thoroughly discuss all available treatment options with their healthcare providers. Exploring non-surgical alternatives, understanding the necessity of the proposed surgery, and considering a second opinion can help ensure that surgical interventions are truly in the patient’s best interest.

Non-Surgical Alternatives – Do They Really Work?

Orthopedic surgery can be highly-effective, but it isn’t always the best path to recovery. Non-surgical methods often deliver similar benefits while avoiding surgical risks. For example, a 2024 study found that physical therapy can reduce pain and improve daily function for many orthopedic conditions just as effectively as surgery, without the risks of an invasive procedure.

Medications can also be a viable alternative to surgery, in some cases. Anti-inflammatory medicines like NSAIDs (Ibuprofen, Naproxen, etc.) help reduce swelling and relieve pain temporarily, making it easier to move and heal. Steroid injections can provide targeted relief for severe inflammation in joints.

Lifestyle changes are another powerful tool. Maintaining a healthy weight reduces stress on joints, especially knees and hips, eases pain and slows joint deterioration. Exercise strengthens muscles around joints, improving stability and preventing further injury.

By exploring these and other non-surgical options first, patients can often achieve significant pain relief and improvement in quality of life. Understanding the full range of available treatments empowers patients to make informed decisions, potentially avoiding surgery while still achieving meaningful relief and better overall health.

The Importance of a Second Opinion

Seeking a second opinion can be crucial when considering orthopedic surgery. It helps clarify the diagnosis, explore alternative treatment options, and reduce the risk of undergoing an unnecessary procedure. A different specialist may recommend a non-surgical intervention or suggest a less invasive approach that aligns better with the patient’s needs.

To get the most from a second opinion, patients should choose an experienced orthopedic specialist, bring all relevant medical records, and ask direct questions about treatment alternatives, risks, and expected outcomes.

Making informed decisions about orthopedic treatment ensures that surgery remains a last resort rather than the first choice. By exploring all options, consulting trusted specialists, and seeking second opinions, patients can take control of their health and find the best path to recovery – one that prioritizes both well-being and long-term mobility.