Research shows physiotherapy is just as effective as surgery in patients with meniscal tears and osteoarthritis of the knee. So before you decide to undergo the surgery with its potential risks, consider physiotherapy can be applied to avoid this.
There were no significant differences in functional improvement after 6 months between patients who underwent surgery with postoperative physiotherapy and those who received standardized physiotherapy alone, say authors of an article published in the New England Journal of Medicine.
The multicenter, randomized, controlled trial involved 351 symptomatic patients aged 45 years or older with a meniscal tear and evidence of mild-to-moderate osteoarthritis of the knee. Subjects were randomly assigned either to surgery and postoperative physical therapy or to a standardized physiotherapy regimen (with the option to cross over to surgery at the discretion of the patient and surgeon). Within six to twelve months, patients who had physiotherapy alone showed similar improvement in functional status and pain as those who had undergone arthroscopic partial meniscectomy surgery.
The results at 12 months were similar to those at 6 months, and the frequency of adverse events did not differ significantly between the groups. This suggest that a dedicated regimen of physiotherapy in these patients may be a reasonable first approach.
The results of this study reinforce practice beliefs which many physiotherapists express when patients often request arthroscopic knee surgery to repair these injuries: surgery may not always be the most prudent initial approach to deal with his situation. The authors say their findings suggest that “these data provide considerable reassurance regarding an initial non-operative strategy.”