Physiotherapy Is As Good As Surgery For Meniscal Tears

Last week Yahoo! News reported that physiotherapy was as good as knee surgery. The claims were based on results of a recent study by Jeffrey Katz, Professor of Medicine and Orthopedic Surgery at Harvard University. The randomised controlled trial involved symptomatic patients aged 45 years or older with a meniscal tear and evidence of mild-to-moderate osteoarthritis on imaging. They randomly assigned 351 patients to surgery and postoperative physiotherapy or to a standardized physiotherapy regimen (with the option to cross over to surgery at the discretion of the patient and surgeon). The patients were evaluated at 6 and 12 months.

They did not find significant differences between the study groups in functional improvement 6 months after randomisation; however, 30% of the patients who were assigned to physiotherapy alone underwent surgery within 6 months. “Since both the patients who received physical therapy and those who received surgery had similar and considerable improvements in function and pain, our research shows … there is no single ‘best’ treatment. Patients who wish to avoid surgery can be reassured that physical therapy is a reasonable option, although they should recognize that not everyone will improve with physical therapy alone.” Katz said.

Having undergone a successful menisectomy last year I can personally attest that surgery can sometimes achieve results that physiotherapy can’t but conservative management such as physiotherapy should always be the first port of call.