Meniscal Tears: Supervised Exercise Therapy as Effective as Surgery
Nearly four million arthroscopic knee surgeries are carried out annually, worldwide, at a cost of billions of dollars, according to the American Orthopaedic Society for Sports Medicine.
Recently, researchers in Norway determined that a supervised course of exercise therapy can produce the same outcome as arthroscopic surgery for meniscus tears in the knee. The recent randomized controlled clinical trial involved 140 middle-aged participants (50 years of age), and was published July 20, 2016 in The BMJ.
What you Should Know
- Meniscus tears are among the most common knee i Athletes, particularly those who play contact sports, are at risk for meniscus tears. However, anyone at any age can tear a meniscus. When people talk about torn cartilage in the knee, they are usually referring to a torn meniscus.
- Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella).
- Two wedge-shaped pieces of cartilage act as “shock absorbers” between your thighbone and shinbone. These are called menisci. They are tough and rubbery to help cushion the joint and keep it stable.
- Older people are more likely to have degenerative meniscus tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. An awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.
Study Process. The participants were divided evenly into two groups, one comprising those in a 12-week exercise therapy course of two to three weekly sessions, and a group undergoing arthroscopic partial meniscectomy.
Patients were assessed at three, 12, and 24 months. The exercise group reported improved muscle strength at three and 12 months, although the improvement did not produce consistently better functional performance at 12 months. The surgical group reported reduced strength at three months and slightly better than baseline at 12 months. However, at 24 months, there was virtually no difference in treatment effect between the two groups.
No Difference in Outcome. Researchers strongly recommended that patients with degenerative meniscal tears and no evidence of osteoarthritis should consider supervised exercise therapy over surgery as a treatment option.
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