Surgery — when, and how to prepare
Surgery is one option, not the destination everyone eventually reaches. This page covers when it is considered, what to ask before deciding, and what recovery usually involves.
When surgery is considered
Among the eleven recommendations that high-quality guidelines for musculoskeletal pain agree on is to offer good non-surgical care before considering surgery. That does not mean surgery is bad; it means the less invasive options deserve a real attempt first.
Surgery is usually considered when:
- symptoms interfere substantially with daily life and have not improved after adequate non-surgical care
- there is structural damage that an operation can genuinely correct
- the condition clearly calls for it from the outset — a displaced fracture, a knee locked by a tear that blocks movement, or an infected joint
In that last group waiting helps nothing, and your surgeon will say so rather than working through a ladder.
When the two come out level
For some problems the evidence puts them close together. A systematic review of 10 randomised trials with 1,525 patients found that in degenerative meniscal tears without locking or catching, a proper physiotherapy programme gave results for pain and function comparable to arthroscopic surgery.
In that situation what should decide it is everything else: the risks of an operation, the recovery time, the cost, and whether this is the right moment for you.
Before deciding
Preparing
- Declare every medicine and supplement, especially blood thinners and diabetes medication
- Declare drug allergies and any past trouble with anaesthesia, your own or in your family
- If you smoke, stopping beforehand helps wound healing and lowers lung complications
- Prepare the house if walking will be hard at first: bring everyday things within reach, clear the floor
- Arrange help for the first week, and a way to get home
Afterwards
Recovery has two parts: tissue that has to heal, and function that has to be retrained. The first takes weeks. The second usually takes months.
Your surgeon will give you a timetable of what is allowed and forbidden at each stage. That timetable matters more than any general advice, because it reflects what was actually done in theatre.
When to see a doctor
Questions to ask your doctor
- What is the goal of this operation in my case?
- If I waited another three to six months, would the result differ?
- How many nights in hospital, and when could I work again?
- What does rehabilitation look like, and when does it start?
- What symptoms afterwards mean I should come straight back?
Frequently asked questions
If I postpone surgery, will it get worse?
It depends on the condition. Some repairs genuinely have a window; other problems wait with nothing lost. Ask directly whether waiting three or six months would change the outcome.
Keyhole surgery means small cuts, so a fast recovery?
The skin incisions are smaller, but recovery depends on what was done inside. A tendon repaired through a keyhole may still need months of care.
Does everyone need physiotherapy afterwards?
Almost every bone and joint operation needs rehabilitation afterwards. The result depends on the months that follow at least as much as on the operation itself.
References
- Lin I et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2019
- Giuffrida A et al. Conservative vs. surgical approach for degenerative meniscal injuries: a systematic review of clinical evidence. Eur Rev Med Pharmacol Sci. 2020
Related conditions
Written by Assoc. Prof. Sorawut Thamyongkit, M.D.