Physical Therapy as Effective as Knee Surgery?

Individuals suffering from a common knee injury plus osteoarthritis have reason to pause before agreeing to surgery right away, a recent study concluded. It rated physical therapy (PT) as effective as knee surgery for a torn meniscus.

The federally funded study compared the results of arthroscopic surgery versus physical therapy at seven major U.S. universities and orthopedic surgery centers, according to The Washington Post. Its 351 subjects had meniscus tears and osteoarthritis.

A meniscal tear is a tear in the meniscus, a C-shaped piece of cartilage that absorbs shocks to the knee, says PubMed Health. The meniscus also helps lubricate the knee joint and affects the ability to flex and extend it. Both twisting and over-flexing are common causes of tears.

The objective of the research was to determine whether arthroscopic surgery for patients with both painful problems provided better outcomes than PT, according to the New England Journal of Medicine, which published the findings.

Subjects were at least 45 years old. Imaging confirmed evidence of mild to moderate osteoarthritis. Patients who initially received physical therapy instead of surgery completed an average of nine sessions, plus at-home exercises.

After six months, both the PT group and the group who initially had surgery reported similar rates of functional improvement. They also submitted similar pain scores. Researchers reported similar results at 12 months.

Around 30 percent of the PT group opted for surgery prior to the six-month mark. However, they scored the same as patients who had surgery initially and as those in the PT group who stuck it out and avoided surgery.

While not the primary motivator for many patients, cost is a consideration for some. The tab for arthroscopic surgery, which occurs nearly half a million times a year for a meniscal tear, is around $5,000 in the United States. This contrasts with $2,000 for a typical course of PT. Given the eagerness of many physicians to perform arthroscopic surgery, exactly how the study will impact patients with both tears and osteoarthritis is unpredictable.

Six years ago, I heard a pop in my left knee while rescuing a cat. An MRI confirmed a torn meniscus. I lived with the pain for three years, until an orthopedic surgeon advised me to have surgery after a second pop. I have not been pain free since the operation, which was followed by 20 PT sessions.

I called halt to the PT when pain had increased and a second MRI showed extensive osteoarthritis plus a Baker's cyst. These findings would have caused me to avoid surgery in favor of PT structured to accommodate the arthritis. In hindsight, I'm convinced physical therapy would have been as effective as knee surgery.

Vonda J. Sines has published thousands of print and online health and medical articles. She specializes in diseases and other conditions that affect the quality of life.

Source: http://news.yahoo.com/physical-therapy-effective-knee-surgery-153100385.html

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