After a meniscal tear, there are two treatment options: physiotherapy or arthroscopy. A Dutch study now compared the success of the two treatment approaches.
A team around Dr. Victor A. van de Graaf of the Municipal Hospital (OLVG) in Amsterdam has enrolled 321 patients with a meniscal tear between the ages of 45 and 70, either for partial arthroscopic resection or physical therapy, with exercise training over a period of eight weeks for her knee.
During the 24-month follow-up period, 29 percent of the patients in the physiotherapy group were then given a partial meniscectomy, while 5 percent of the patients in the surgery group were not operated on. The success of the two therapies was ultimately determined by the improvement in knee function, which was recorded using the IKDC (International Knee Documentation Committee) score.
Patients in the partial meniscectomy group showed an improvement of knee function by 26.2 points, in patients from the physiotherapy group the value improved by 20.4 points. Since the researchers had decided at the beginning of the study to find a difference only from a value of eight points significantly, they came to the conclusion that after a meniscal tear the physiotherapy as well as help the arthroscopy.
"Our findings confirm the findings of previous studies and justify an initial conservative approach in patients older than 45 years with a non-disabling meniscal tear," van de Graaf concludes. Physiotherapy was a patient-friendly alternative to early surgery. If there is no improvement in the long term with physiotherapy, then surgery can still be carried out.
In total, 18 patients in the arthroscopic partial meniscectomy group and 12 patients in the physiotherapy group experienced adverse events: the most frequent were repeated operations (three in the arthroscopy group and one in the physiotherapy group) and additional physician visits of knee pain (six in the arthropodia group and two in the physiotherapy group).