Meniscal Tears

A recent study in the New England Journal of Medicine compared physical therapy to arthroscopic surgery for knee meniscal tears and early osteoarthritis.

The study was randomized with 351 participants divided into a surgery group and a physical therapy group. To be eligible for the study the participants had to have signs of a meniscal tear that included: clicking localized knee pain, giving way and catching.

The physical therapy group attended therapy 1-2 x per week for 6 weeks.

The treatment consisted of manual therapy, specific therapeutic exercises, cardiovascular conditioning and modalities such as ice and electrical stimulation.

The authors concluded that patients with a meniscal tear and evidence of mild to moderate osteoarthritis that were assigned to the arthroscopic surgery group (with postoperative physical therapy) and physical therapy group both had very similar improvements in function and pain.

Within the physical therapy group 70% percent of the patients had a successful outcome.

However, 30% of patients assigned to the physical therapy group went on to have surgery within the first 6 months (as they did not meet the study’s criteria for success). It is important to note that the patients in the physical therapy group, who did not improve enough, who then went on to have surgery, had as good a final outcome with those that had surgery immediately.

It is important to remember that this study was performed in the U.S. where surgery can be performed immediately, whereas in Canada there typically is a longer wait. So considering this study’s results and our wait times in Canada, if you have a meniscal tear get to physical therapy. Maybe you won’t even need surgery!