US/World

Physical Therapy As Good As Surgery For Knee Repair

Rehabilitation within a day of knee replacement pays off
Physical therapy for meniscus injury in the knee is just as effective as surgery after one year. Creative Commons

A new report in the New England Journal of Medicine makes a rigorous comparison of therapy versus surgical intervention for the repairing of a torn meniscus. 

The meniscus is the cartilage that cushions the knee and prevents wear between bones.  Around 33 percent of people over 50 have a tear on the cartilage in one of their knees and having arthritis makes the situation to occur more often.

The researchers found that physical therapy cost far less and carried far fewer risks from the surgery, yet surgery was effective in repairing the problem quicker but was more than double the price.  Surgery would fix the problem instantaneously, but therapy could take between 6 months and one year to repair the damage.

"Both are very good choices. It would be quite reasonable to try physical therapy first because the chances are quite good that you'll do quite well," said one study leader, Dr. Jeffrey Katz, a joint specialist at Brigham and Women's Hospital and Harvard Medical School.

The federally funded study involved seven major universities and nearly half a million people who had knee problems and were either told to go for surgery or physical therapy.  After 6 months both groups had similar functional improvement and pain scores.  Thirty percent of patients who were in physical therapy had to get knee surgery because the therapy was not working. They had similar results as those who had surgery to begin with.

Surgery costs about $5,000, compared with $1,000 to $2,000 for a typical course of physical therapy.

Rachelle Buchbinder of Monash University in Melbourne wrote in a commentary in the medical journal that therapy "is a reasonable first strategy, with surgery reserved for the minority who don't have improvement." 

The research published int he New England Journal of Medicine can be found here

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