Is Exercise Therapy an Effective Alternative to Surgery for Meniscal Tears?
Is Exercise Therapy an Effective Alternative to Surgery for Meniscal Tears?
Did you know that physical therapy can often produce the same results as surgery for meniscus tears? For millions of people facing this injury, choosing the right treatment is a crucial decision that impacts their mobility and quality of life.
What is the Meniscus?
The meniscus is a crescent-shaped cartilage in the knee joint, sandwiched between the femur (thigh bone) and tibia (shin bone). Each knee has two menisci—one on the inner side (medial) and one on the outer side (lateral). Their primary roles are to:
Act as shock absorbers, distributing weight across the knee joint.
Stabilize the knee by keeping it aligned during movement.
Protect the cartilage from wear and tear.
A damaged meniscus disrupts these functions, leading to pain, swelling, and difficulty in everyday activities like walking or climbing stairs.
How Many People Are Affected by Meniscal Tears?
Meniscal tears are one of the most common knee injuries, affecting millions each year. While anyone can suffer from a tear, it is typically found in:
- Act as shock absorbers, distributing weight across the knee joint.
- Stabilize the knee by keeping it aligned during movement.
- Protect the cartilage from wear and tear.
Physical Therapy vs. Surgery: What Does the Research Say?
Comparable Outcomes: For older adults with degenerative tears, physical therapy is as effective as APM in improving knee function and reducing pain.
Surgery for Younger Patients: Those with traumatic tears or mechanical symptoms like knee locking may benefit more from surgery, particularly if they aim to return to high-intensity activities such as sports.
Fewer Risks with PT: Non-surgical options avoid complications like infections or accelerated arthritis progression, which can occur after surgery.
Interestingly, 25-40% of patients who start with physical therapy eventually opt for surgery, often due to persistent symptoms.
Practical Implications
When deciding between surgery and physical therapy, consider the following:
- Age and Activity Level: Younger, active individuals may lean toward surgery, while older adults might benefit equally from PT.
- Type of Tear: Traumatic tears may require surgery, whereas degenerative tears often respond well to non-surgical care.
- Long-Term Goals: For those seeking to avoid risks and costs, physical therapy offers a safer alternative.
New research on this topic is constantly emerging. Here are some additional articles and resources you may find valuable:
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References
Damsted, C., Skou, S. T., Hölmich, P., Lind, M., Varnum, C., Jensen, H. P., Strange Hansen, M., & Bloch Thorlund, J. (2024). Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults--An Exploratory Analysis From the DREAM Trial. Journal of Orthopaedic & Sports Physical Therapy, 54(5), 340–349.Noorduyn, J. C. A., van de Graaf, V. A., Willigenburg, N. W., Scholten-Peeters, G. G. M., Kret, E. J., van Dijk, R. A., Buchbinder, R., Hawker, G. A., Coppieters, M. W., Poolman, R. W., & ESCAPE Research Group (2022). Effect of Physical Therapy vs Arthroscopic Partial Meniscectomy in People With Degenerative Meniscal Tears: Five-Year Follow-up of the ESCAPE Randomized Clinical Trial. JAMA network open, 5(7), e2220394.
van de Graaf, V. A., van Dongen, J. M., Willigenburg, N. W., Noorduyn, J. C. A., Butter, I. K., de Gast, A., Saris, D. B. F., van Tulder, M. W., Poolman, R. W., & ESCAPE Research Group (2020). How do the costs of physical therapy and arthroscopic partial meniscectomy compare? A trial-based economic evaluation of two treatments in patients with meniscal tears alongside the ESCAPE study. British
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