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Is surgery better than physical therapy if you have arthritis and meniscal tears?

Absolutely NOT. In a recent report in the New England Journal of Medicine (Katz, J. N., Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. March 19, 2013 DOI:

knee pain

knee pain

10.1056/NEJMoa1301408) researchers looked at over 351 patients 45 years or older that reported knee pain while suffering from meniscal tears and mild to moderate arthritis. Two groups were randomly assigned to either surgery followed by physical therapy or physical therapy alone. At 6 months there was no difference between the groups in functional outcomes and pain levels.

Sometimes, with simple activity modifications and rest, but no surgery or regimen of physical therapy, patients can see results with the passage of time. But, if after 2-3 months symptoms persist, I get more concerned that time and rest are not the solution. If you experience significantly reduced range of motion, severely altered gait and muscle atrophy, I recommend that you seek physical therapy and possibly orthopedic evaluation.

If your orthopedist suggests surgery, be sure to ask, “What are the risks if I wait to have the surgery performed?” Complications of any invasive procedure such as surgery vary but are always possible, so surgery is a risky alternative. Try physical therapy first. This research suggests that surgery for meniscal repair may not be helpful. However, with the improved durability of joint replacement materials and improved surgical techniques, knee replacement may be indicated.

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