The meniscus is a piece of cartilage that acts as a cushion between the thighbone and shinbone. A sudden movement like a twist or repetitive squatting can cause a tear in this piece of knee cartilage. Meniscal tears can affect people of all ages. The condition causes knee pain and swelling, and also affects range of motion.
Professional pain management centers offer conservative treatments for meniscal tears, which include a range of non-surgical options. However, every year, many people have knee arthroscopy or surgery for this disabling knee injury. Now, a new study published in BMJ says that exercise is as effective as surgery to treat the condition in middle-aged patients.
The aim of the study conducted by a European research team was to evaluate the use of surgery as a treatment option for meniscal tears. The lead author, an orthopedic surgeon at a hospital in Sandvika, Norway, tracked outcomes for 140 patients with degenerative meniscal tears. The patients were about 50 years old and generally did not have any symptoms of arthritis.
The patients were divided into two groups: one half performed two to three supervised exercise sessions a week for three months and the other half had knee (keyhole) surgery, followed by simple daily exercises at home. The study showed that:
- After three months, only the exercise group showed improved thigh strength.
- After two years, pain, sports and recreation function, and knee-related quality of life were similar for both groups.
- Though 13 (19 percent) of the patients in the exercise group also had knee surgery during the study follow-up period, they did not experience any additional benefits.
The researchers concluded that exercise therapy should be considered for middle-aged patients with meniscal tears.
Commenting on the study findings, two U.S. based orthopedic experts said that the results confirm prior research that exercise benefits most patients significantly over weeks to months. However, they point out that the size and cause of the tear matters and the study results are most likely to apply to patients with small degenerative tears. One orthopedic surgeon said that middle-aged, athletic individuals who sustain sports injuries leading to meniscal tears were not included in the study population. The benefits of knee surgery could be better understood only if these individuals were examined as they formed a major part of the patients seeking treatment for meniscal tears.
Nevertheless, both experts agreed that conservative treatments such as exercise should be the first line of action for meniscus tears.
Orthopedic experts in reliable New York health care centers thoroughly evaluate each patient to recommend the best treatment option. Moreover, they will advise surgery only if conventional pain management strategies, including physical therapy exercises, do not work.