A new study funded by the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases, and published in the New England Journal of Medicine, suggests that surgery need not always be the answer (or best approach) for a torn meniscus, especially in middle aged or older individuals with knee osteoarthritis (OA).
In the … trial, researchers at Brigham and Women’s Hospital in Boston and at six other clinical centers around the nation, compared surgery with physical therapy to determine if one treatment course led to better outcomes over the other. They recruited 351 men and women ages 45 and older who had mild to moderate knee OA and meniscal tear. … Patients assigned to physical therapy had the option of undergoing surgery later in the trial if they wished. The researchers assessed each patient’s progress over one year, tracking improvements in functional status and pain levels at six months and at 12 months.
After six months, both groups experienced similar and substantial improvement in function and pain levels. However, 30 percent of patients assigned to physical therapy alone elected to undergo surgery within six months of enrolling in the study because their symptoms were not improving or were worsening. The people who remained in the physical therapy group through the end of the 12-month period continued to show improvements that were equivalent to those who had surgery.
Avoiding surgery can be the right choice for many reasons, including financial and additional adverse medical conditions. And while some may still require surgery, it is good to know there is an option to consider before undergoing treatment that could lead to escalation of the issues involved with knee OA or other long term effects from a surgical procedure.