Physical Therapy Might Trump Knee Surgery

Physical therapy for torn meniscus may work as well as knee surgery and have fewer negative effects

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Surgery may not always be the best option for patients. In the case of some knee problems, physical therapy may work just as well and have fewer negative effects.

Many people choose surgery to repair a torn meniscus. But a new study found that this may put patients at high risk for developing arthritis and cartilage loss.

But physical therapy may be an effective alternative to surgery for a torn meniscus, according to past research.

"We found that patients without knee osteoarthritis who underwent meniscal surgery had a highly increased risk for developing osteoarthritis and cartilage loss in the following year compared to those that did not have surgery," said lead study author Frank W. Roemer, MD, of the Boston University School of Medicine, in a press release.

Dr. Roemer and team reviewed exams of 355 patients who developed osteoarthritis of the knee during a five-year period. Osteoarthritis is a condition caused by a wearing down of protective cartilage. It may cause pain and reduce joint function.

In this study, 31 patients had knee surgery on the meniscus a year before being diagnosed with arthritis. A total of 280 of the patients' knees had signs of meniscal damage but did not have surgery.

The meniscus is a crescent-shaped piece of cartilage that acts like a shock absorber in the knee. It also helps with stability. Patients may tear it if they are physically active (by playing sports, for instance). Many, however, develop tears from wear and aging.

Dr. Roemer and colleagues determined the chance of developing arthritis and cartilage loss one year after having meniscus damage. They found that all 31 of the patients who had undergone knee surgery developed arthritis within a year. However, only 59 percent of the patients with meniscal damage who did not have knee surgery developed arthritis within a year.

These researchers noted that cartilage loss was about twice as prevalent among those who had surgery. They observed cartilage loss in about 80 percent of the patients with knee surgery and in about 40 percent of the patients with meniscal damage but no surgery.

Dr. Roemer and team assessed patients' knee condition by reviewing MRI scan images of the joints. The patients were 60 years old on average. Most were overweight.

Dr. Roemer said that "meniscal surgery might need to be discussed more carefully in order to avoid accelerated knee joint degeneration.”

Physical therapy may serve as an alternative to surgery. Therapy may maintain and restore muscle strength and range of motion.

An estimated 700,000 arthroscopic surgeries are performed on the meniscus each year in the US, according to a 2013 study published in The New England Journal of Medicine. An arthroscope is a tool that lets a doctor inspect and operate on the interior of a joint.

This past research based in Finland suggested that physical therapy may be just as effective as surgery in treating a torn meniscus.

The new study by Dr. Roemer and colleagues was presented Dec. 3 at the annual meeting of the Radiological Society of North America in Chicago. Research presented at conferences may not have been peer-reviewed.

The authors disclosed no funding sources or conflicts of interest.

Review Date: 
December 3, 2014
Last Updated:
December 3, 2014