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This is the first edition of our evidence-based practice series - your one stop destination for all your musculoskeletal research needs. We are committed at Square One Chiropractic to deliver the best, research-congruent care to our patients. At Square One Chiropractic, we believe in educating our patients on the pain treatment options available in Singapore and to allow you to come to your own informed decision. Shared-decision making is our promise to you! Is standard medical care always better?There has been a lot of media coverage questioning common, standard medical procedures. The issue in concern is that these procedures' effectiveness are not supported by research data. Some surgeries for low back pain has come under fire for being virtually useless (Canberra Times, 2018) and is a significant contributor to increasing healthcare costs (The Conversation, 2018)! Opioid medications have also been found to be not only of little benefit but also puts patients at risk of serious side effects (SBS News, 2018). Earlier this year, Scientific American posted an article (How Fake Surgery Exposes Useless Treatments) to push for patients considering surgery to try conservative care first!Do you know that knee pain is the most common pain complaint in older adults?Family Practice, Oxford University (2007)Musculoskeletal pain affects up to 44 per cent of Singaporeans (The Straits times, 2015) and the number of people with knee pain has doubled since World War II (Science, 2017). But is surgery the solution to your problem? Sham Orthopaedic Surgery As Effective As Real Surgery!A study by prestigious journal Pain Medicine in 2017 found that fake orthopaedic surgeries (including knee surgeries) were as effective as real surgeries in reducing pain and improving disability! Given the case, how do we know real surgery actually work? Placebo? Knee Osteoarthritis is Higher in Operative vs. Nonoperative Treatment In a 2018 study, 80% of patients who had knee surgery had knee arthritis compared to 68% in the group who did not have surgery. Furthermore, after 20 years, there was no difference in both subjective and objective functional outcomes in both groups. Surgery Increases Risk of Joint Damage Another 2018 study by prestigious Bone and Joint Journal found knee surgery (partial meniscectomy) to be strongly associated with the progression of cartilage damage. While knee surgeries are fairly safe, what are the long term effects of surgical treatment. Is it necessary? No Better Long Term Results When Compared to RehabWhat? Yes, you hear me right. A 2013 study found that ACL (anterior cruciate ligament) reconstruction did not yield better results than rehab alone at 5-year follow up. Sure, you tore your ACL but do you need it reconstructed? May not.What do I do now?There is always a place for standard medical care and to seek surgical solutions for your pain. Before heading straight to the surgeon's office, why not give conservative care a shot? Exercise and chiropractic care have been reported to be an effective and cheaper treatment option for knee pain (Asia One & The Joint). We offer effective solutions for your knee pain at Square One. Why not give us a try? Surgery can wait.Do you know Square One Chiropractic is first rehab-focused chiropractic clinic established in Singapore? We believe that movement is medicine and that an active lifestyle is your key to a full, functional, and happy life. Book your appointment online and start exercising to your recovery with us today! Science Source:Risk factors for progression of articular cartilage damage after anatomical anterior cruciate ligament reconstruction. Bone and Joint Journal. 2018.Twenty-Year Follow-up Study Comparing Operative Versus Nonoperative Treatment of Anterior Cruciate Ligament Ruptures in High-Level Athletes. American Journal of Sports Medicine. 2018Sham Surgery in Orthopedics: A Systematic Review of the Literature. Pain Medicine. 2017Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ. 2013

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