A new study shows that therapy is almost as good as having knee surgery for improving movement and reducing pain for some with knee arthritis or even torn knee cartilage.
Results of the study were discussed on Tuesday at an American Academy of Orthopaedic Surgeons conference in Chicago. Results were published online by the New England Journal of Medicine.
Many older adults have severe knee pain due to a tear in the meniscus, a crucial support structure in the knee that is often damaged in people with knee osteoarthritis.
Each year in the United States, more than 450,000 arthroscopic surgeries are performed to treat meniscal tears, but that could be a thing of the past.
Researchers at Brigham and Women’s Hospital in Boston studied 351 patients all over the age of 45-years old with knee pain, meniscal tear or knee osteoarthritis.
The study participants were randomly assigned to be treated with either arthroscopic surgery or physical therapy. When they were assessed six and then again 12 months later, both groups had substantial and similar improvements in movement.
“Since both the patients who received physical therapy and those who received surgery had similar and considerable improvements in function and pain, our research shows that there is no single ‘best’ treatment,” said Dr. Jeffrey Katz director of the Orthopedic and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital, and a professor of medicine and orthopedic surgery at Harvard Medical School.
However, Dr. Katz noted that some of the physical therapy patients did eventually have surgery. “Patients who wish to avoid surgery can be reassured that physical therapy is a reasonable option, although they should recognize that not everyone will improve with physical therapy alone. In this study, one-third of patients who received physical therapy ultimately chose to have surgery, often because they did not improve with [physical therapy].”
“There are patients who would like to get better in a ‘fix me’ approach” and surgery may be best for them, added Elena Losina, another study leader from Brigham and Women’s Hospital.
Knee surgery costs about $5,000, compared with $1,000 to $2,000 for physical therapy, Katz said. Adding that, “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.”
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