Degenerative meniscal tears are a common knee problem, especially among older adults. While surgery has traditionally been considered a primary treatment option, there is growing evidence to support physical therapy as a preferred and effective alternative. Research shows that there is no subgroup of patients with confirmed degenerative meniscus tears who benefit from arthroscopic partial meniscectomy (surgery) compared to non-surgical or sham treatment. It is also important to recognize that “degenerative meniscus tears detected on MRI are not necessarily the cause of symptoms in these patients 6as degenerative meniscus tears are frequent incidental findings in asymptomatic knees”.
It’s important to note that while a degenerative meniscal tear may not always cause pain, it can still contribute to knee instability, reduced joint function, and an increased risk of future injuries. Additionally, pain perception is highly individual and what may not be painful for one person can be debilitating for another. This blog post will explore why physical therapy is often a better choice than surgery for managing degenerative meniscal tears.
Understanding Degenerative Meniscal Tears:
Before diving into treatment options, it’s essential to understand what a meniscal tear is. The meniscus is wedge-shaped cartilage in the knee that acts as a shock absorber. Tears can occur due to sudden trauma or as part of the aging process and wear and tear on the knee joint, leading to a range of symptoms. Unlike traumatic tears, these tears often develop gradually and are associated with arthritis.
Why Physical Therapy Trumps Surgery:
Non-Invasive Approach:
Physical therapy offers a non-invasive approach to managing degenerative meniscal tears. It doesn’t involve surgery, anesthesia, or the associated risks and recovery time. Surgery, including meniscectomy (removal of a portion of the meniscus), can lead to a reduction in meniscal tissue which decreases the inherent shock absorption and stability of the knee joint. Physical therapy also focuses on preserving and optimizing the use of the existing meniscus.
Pain Management:
Physical therapists are experts at pain management. They employ various techniques such as manual therapy, joint mobilization, and modalities to reduce pain and discomfort in the knee.
Strengthening and Stability:
Strengthening the muscles around the knee joint is crucial for stability and reducing strain on the meniscus. Physical therapists create tailored exercise programs that progressively build strength, offering enhanced joint support.
Range of Motion:
Physical therapists work on improving knee joint range of motion, which can be significantly limited in individuals with degenerative meniscal tears. This not only alleviates pain but also enhances mobility.
Functional Improvement:
The goal of physical therapy is to help patients regain the ability to perform daily activities and movements. This includes activities like walking, climbing stairs, and even participating in low-impact sports.
Long-Term Management:
Surgery may offer temporary relief, but it doesn’t address the underlying degeneration. Physical therapy focuses on long-term management, teaching patients strategies to manage their condition and reduce the risk of future issues.
Avoiding Surgery Risks:
Surgery carries inherent risks, including infection, anesthesia complications, and the possibility of limited success. Physical therapy provides a lower-risk alternative that can yield excellent results.
Personalized Care:
Physical therapy plans are highly individualized. Therapists assess your specific condition and tailor treatment to your needs, ensuring a personalized approach to your recovery.
Choosing physical therapy over surgery for degenerative meniscal tears is a wise decision for many individuals. It offers a non-invasive, patient-centered approach to pain management, functional improvement, and long-term knee health. While surgery may still be necessary in some cases, it is best reserved for severe, specific types of tears.
Remember that each person’s condition is unique, so it’s essential to consult with a healthcare provider who can assess your specific circumstances and recommend the most suitable treatment approach. In many cases, physical therapy empowers individuals to regain their quality of life without the need for surgery, proving that a conservative approach can triumph over more invasive options.
References:
Arthroscopic partial meniscectomy vs non-surgical or sham treatment in patients with MRI-confirmed degenerative meniscus tears: a systematic review and meta-analysis with individual participant data from 605 randomized patients. S.R.W. Wijn et al. / Osteoarthritis and Cartilage 31 (2023) 557e566
