Therapy May Be as Good for Knee Damage as Surgery in Some Patients

By Makini Brice | Update Date: Mar 19, 2013 01:43 PM EDT

For some knee damage, it may be a better idea to pursue physical therapy over surgery. A recent study found that physical therapy improved movement and pain, as well as cost less money than surgery.

The meniscus is a disc that cushions the knee with cartilage. According to the Associated Press, one third of people have a tear in the meniscus, and having arthritis makes it more likely. Though a tear does not have any symptoms, it is extremely painful. Unfortunately, that pain can often be confused with the pain brought on by arthritis.

As a result, in the United States alone, 450,000 arthroscopic surgeries are performed, according to Health Day. The problem is that there is no current system in place that doctors can use in order to determine whether physical therapy or surgery is the better treatment for patients.

The study was conducted by researchers from seven universities. In total, 351 people over the age of 45 participated in the study; all suffered from knee pain, a tear in their meniscus and osteoarthritis in their knee. Participants were randomly assigned to physical therapy or arthroscopic surgery. After six and 12 months, both groups were assessed. Both groups had similar levels of improvement and pain scores after six months.

Before the six-month mark, 30 percent of patients assigned to the physical therapy group opted to have the surgery. However, these patients reported the same level of improvement in function and in pain as patients who had continued with the physical therapy, as well as patients who had the surgery at the start of the trial.

While both treatments came out even in terms of functional and pain improvement, therapy did  come out ahead in one category: cost. Physical therapy costs about $1,000 to $2,000, while surgery costs about $5,000.

"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," Dr. Jeffrey Katz, the study's principal investigator, said in a statement.

The study was published in the New England Journal of Medicine.

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