Knee Replacement Surgery - An Overused Intervention
The clinical history in a patient with arthritis of the knee is dominated by significant and disabling pain. The pain predominantly occurs while standing and walking. However, as the arthritis progresses, the pain may be constant and unrelieved by rest (e.g., night pain). In addition to pain, other symptoms include stiffness, swelling, locking of the knee joint, and weakness.
Osteodegenerative Arthritis of the knee is the most common reason that surgeons advise total knee replacement, in which all cartilage is removed from the knee joint and a metal or plastic implant is substituted. Approximately 130,000 knee replacement surgeries (femoral surface replacement) are performed every year in the United States.
However, in a paper published in 2005 (Squire et al), 37 knee joint replacements were reviewed. The surgical failure rate was reported at 40.5% (failure defined as patients requiring a 2nd surgery on the same knee).
Why the extraordinary high failure rate? The answer became apparent to me as a result of my research on foot function. In a landmark paper, An Innovative Mechanical Approach in Treating Chronic Knee Pain. A BioImplosion Model (Rothbart,1994); I linked degenerative knee joint disease to the feet.
I found that certain inherited foot structures force the feet to twist while standing or walking. This foot twist causes the knees to rotate inward (See Figure 1 below). This inward rotation results in a misalignment of the knee joint. The misalignment causes abnormal wear patterns (where the cartilage wears unevenly) in the knee joint (See Figure 2 below). This is similar to a car alignment problem which can lead to uneven wear patterns in the tires. The knee becomes inflamed and arthritic.
Unless X-ray findings demonstrate a destruction of the bone surfaces within the knee joint and not just a wearing down or thinning of the cartilaginous tissue, I believe that is is unwise to consider knee replacement surgery. The reason is because cartilaginous tissue does regenerate if the cause of its degeneration is determined and reversed. This negates the need for surgical intervention.
Once I understood that one of the primary causes of knee pathology was foot twist, I invented a therapy to eliminate the foot twist, which in turn, places the knee joints in a better alignment, protecting the knee cartilage from wearing down and promoting its regeneration. This therapy, called Rothbart Proprioceptive Therapy, has eliminated the need for a vast majority of knee replacements.
Figure 1 - note the valgus (inward)
rotation of the left knee, which is the
result of foot twist
Figure 2 - misaligned knee joint.
The red arrow points to the
loss of cartilage
Professor/Dr. Brian A. Rothbart
Chronic Pain Elimination Specialist
Discovered the Rothbarts Foot and the PreClinical Clubfoot Deformity
Developer of Rothbart Proprioceptive Therapy
Designer of Rothbart Proprioceptive Insoles
Founder of International Academy of Rothbart Proprioceptive Therapy
Author of Forever Free From Chronic Pain
Sign Up Now to get a free chapter from my book, Forever Free From Chronic Pain
References
Squire M, Fehring T, Odum S, W.Griffin, Bohannon Mason J, 2005. Failure of Femoral Surface Replacemen for Femoral Head Avascular Necrosis. Journal of Arthroplasty, Volume 20, Issue null, Pages 108-114.
Rothbart BA, Yerratt M. 1994. An Innovative Mechanical Approach to Treating Chronic Knee Pain. A BioImplosion Model. The Pain Practitioner (formerly American Journal of Pain Management) 4(3):13-18.
Posted by rothbart at 11/10/2009 4:47 PM 
Categories: Symptoms
Tags: Knee Surgery Foot Twist Knee Arthritis Rothbart Proprioceptive Therapy
Categories: Symptoms
Tags: Knee Surgery Foot Twist Knee Arthritis Rothbart Proprioceptive Therapy
Hi, Thanks for sharing such a wonderful piece of information. I must say that while reading your post I found my thoughts in agreement with the topic that you have discussed, which happens very rare.
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I am pleased that you found this information helpful. You may also like to read Why Hip and Knee Joint Replacements May Not Eliminate Your Pain
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One of my friend has gone through the knee replacement surgery few time before and is much better now. I liked the information that you have shared. Appreciable!
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You are most welcome.
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