Why the Best Surgeons Will Refuse to Cut You

Why the Best Surgeons Will Refuse to Cut You
From a Physiotherapist’s Perspective

As a physiotherapist, I see it all the time: patients frustrated with ongoing muscle or joint pain—especially in areas like the knees or hips—come to me in search of a “fix.” They want answers, solutions, and, quite often, a magic bullet to eliminate their discomfort and get back to life as usual.

When conservative treatment takes time or progress is slower than hoped, it’s not uncommon for patients to seek a surgical opinion. They’re often convinced that surgery will provide the immediate and lasting relief they’re after. But then, something surprising happens: the surgeon says no. And not just any surgeon—the reputable, evidence-based ones.

This can be incredibly disappointing for patients. “Why won’t they fix it?” they ask. “What am I supposed to do now?”

The truth is, when a good surgeon refuses to operate on your degenerative knee or hip condition—such as osteoarthritis or a meniscal tear that has come on gradually rather than from a specific injury—they’re actually doing the right thing.

Let me explain.

The Evidence Against Premature Surgery

We now have a wealth of research showing that surgical interventions for many degenerative joint conditions, like arthroscopic surgery for knee arthritis or meniscal tears, are no more effective than structured physiotherapy in improving pain and function. In fact, surgery may carry unnecessary risks, costs, and long-term consequences, especially if performed prematurely.

Yet, there are still some practitioners and surgeons—those less grounded in current evidence—who may recommend or perform surgery before conservative options have been fully explored. Unfortunately, this can lead to outcomes that are less than optimal.

What You Can Do Instead: The Power of Exercise Therapy

Before considering surgery, one of the best steps you can take is to commit to a structured, evidence-based physiotherapy program. One of the leading examples of this approach is the GLA:D® Program.

What is the GLA:D® Program?

GLA:D® (Good Life with osteoArthritis in Denmark) is an education and exercise program developed by researchers in Denmark for people with hip or knee osteoarthritis. It’s been shown to reduce pain, improve function, and even delay or prevent the need for surgery in many cases.

The program combines:

• Education sessions to help you understand your condition and how to manage it.
• Supervised neuromuscular exercise sessions to improve strength, stability, and function.
• A focus on long-term self-management, empowering patients to stay active and in control of their joint health.

Studies have shown that participants in the GLA:D® program report less pain, take fewer pain medications, and feel more confident in their ability to move—often leading to a better quality of life without the need for surgery.

A Surgeon’s “No” Can Be a Gift

When a surgeon declines to operate, it’s not because they don’t care. In fact, it’s often the opposite. They are following the best available evidence, prioritizing your long-term health, and avoiding unnecessary intervention. That “no” is a sign of a good surgeon who is putting your best interests first.

It may be tempting to keep searching for someone who will say “yes” to surgery, but before going down that road, ask yourself: have I really given physiotherapy and conservative management a fair chance?

If you haven’t yet explored options like the GLA:D® program or a dedicated strengthening and mobility plan, that may be the exact prescription you need—not a scalpel.

Final Thought:
Surgery has its place, and when truly needed, it can be life-changing. But the best surgeons—the ones you really want on your team—are the ones who will tell you not to have surgery when it’s not in your best interest. As your physiotherapist, I’m here to guide you through those other powerful options first.

Let’s work together to get you stronger, more mobile, and back to doing the things you love—without going under the knife.

Michael Pierce

Sports Physiotherapist

Lake Health Group