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Menosectomy

This lack of general understanding of function becomes a serious problem when surgery is used beyond the initial treatment for trauma. 'Elective' patch ups are attempted such as in repairing meniscus tears or even removing the section of the torn tissue based on the incorrect assumption that it doesn't repair.

I am concerned when invasive modifications are attempted on very fit healthy individuals such as runners. Subtle faults in repetitive movement cause running injury often referred to as overuse injury by those who do not understand how the problems occur. Surgical modification based on the two dimensional understanding and focussing on isolated segments of the limb is invasive and will not succeed in correcting leg alignment and function.

Recent large scale research has found that knee reconstructions do not improve knee function long term and I will suggest why this is so:

Orthopedic texts show the skeleton dangling like the one on the pole in the surgeons rooms. The legs dangle from the pelvis and the explanations say leg length differences sometimes occur because the pelvis has tilted sideways drawing one hip up and making that leg functionally longer. It is also believed that hip structure or function can affect the alignment of the leg and foot and in fact cause problems in that area. Orthopedic handout sheets and web sites recommend tightening knee ligaments to stabilise the foot. I studied physics before the pure science of biomechanics and I can tell you that we stack up from the base and the knee derives it’s stability from a correctly aligned foot and ankle below. Surgeons generally view the knee in a two dimensional aspect where as it is a three dimensional structure. Looking at the knee in isolation and carrying out realignment procedures is reckless when if you stand back and look at the entire leg/foot as a complete functioning limb, those with problem knees are found to have a foot that rolls and a leg that turns. Most of us have this problem to some degree. Many mainstream professionals are stuck in the past following ideas that were created without the benefit of science. As I have said, it is not enough to be familiar with the anatomy. An understanding of the actual weight bearing function is needed.

There is a need to take note of the well regarded texts from their own more forward thinking peers. See in the solution, 'skeletal variations', the explanation by P & R (Professors of orthopedics Sweden and U.S.). This well regarded and widely available text explains that skeletal variations cause leg rotation with knee, hip, foot and leg injury. In view of that, for any surgeon to view the knee as an isolated two dimensional joint and make drastic surgical modifications is in a word, reckless.

 

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