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Therapy or Surgery? Weighing the Best Option for Meniscus Tears

Therapy or Surgery? Weighing the Best Option for Meniscus Tears
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Every so often, you may hear about a professional athlete injuring their meniscus. A C-shaped layer of cartilage buffering the thighbone and shinbone, the meniscus represents an indispensable cog in the knee joint. Given its importance, meniscus tears are rightfully considered to be a serious medical issue. Recent evidence suggests that physical therapy might be surprisingly effective against this common injury.

Under the Knife… Or Into the Therapist’s Office

A 2013 study concluded that, when it comes to meniscus tears, physical therapy programs may be as useful as surgical procedures. The report appeared in the New England Journal of Medicine, and was authored by a team of surgeons from Brigham and Women’s Hospital and six other health care providers.

For their research, the surgeons enlisted a total 351 adult men and women. Each of these participants had not only suffered meniscus tears, but were also struggling with the effects of osteoarthritis. In addition, all of the subjects were at least 45 years old.

At the onset of the study, the volunteers were split into two groups of nearly equal size. One group had their knees treated first with surgery, followed by physical therapy. The remaining subjects were required to mend their injuries using physical therapy only. It is worth noting that people in the latter group could chose to have meniscus surgery if therapy proved insufficient.

The surgery used for those participating in this study is known as arthroscopic partial meniscectomy. During this procedure, a surgeon will remove sections of the meniscus that are no longer stable. WIth this step out of the way, the surgeon can then smooth out any frayed ends in the remaining cartilage.

Two Checkups

Six months into the study, the authors recorded the progress (or lack thereof) of their subjects, measuring both pain levels and overall functionality of the affected knee. This same information was once again documented at the study’s one year mark. The research team noted that, within the first six months of the trial, roughly 30 percent of those initially in the therapy-only group elected to go the surgical route.

Despite these defectors, the pain/functionality measurements revealed significant improvement in both groups. Between the two checkpoints, the knee health of those who continued to undergo physical therapy steadily improved. In fact, after a full 12 months, the pain levels and functionality scores of these subjects equaled that of the surgery recipients.

The report’s lead author, Dr. Jeffrey N. Katz, believes the study indicates that physical therapy can be a viable alternative to surgery. “We did this trial because surgeons really haven’t been sure what’s best for these patients,” stated Katz. ““Now we have a better picture, and can advise people with knee osteoarthritis and a torn meniscus that physical therapy and surgery are both good options.”

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