Surgery vs physical therapy for meniscal tear

Physical therapy may be used as effective as surgery when it comes to fixing a tear in the meniscus.

Many middle aged and older adults experience knee pain because of a tear in the meniscus, a supporting structure in the knee that is often damaged in those with underlying knee osteoarthritis. Surgery is often used to treat the complaint, but there is little data on who is suitable for surgery and who should be treated with physical therapy.

A US study of 351 patients over 45 years old with knee pain, meniscal tear and knee osteoarthritis separated the patients into groups: surgery versus physical therapy.

Improvement in functional status was assessed after six and twelve months.

Both groups had substantial and similar improvements. But one-third of people in the physical therapy group chose to have surgery over the course of the study. The remaining two-thirds in the physical therapy group did achieve similar improvements in pain and physical function compared to the surgical group.

The implications

“Patients who wish to avoid surgery can be reassured that physical therapy is a reasonable option, although they should recognise that not everyone will improve with physical therapy alone,” says Dr Jeffrey Katz who led the research. “In this study, one third of patients who received physical therapy ultimately chose to have surgery, often because they did not improve with physical therapy.

Next steps

The results of the study should help healthcare professionals identify the treatment that is best for individual patients.