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Exercise therapy could be used instead of surgical meniscus repairs, study shows

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A new study has found that most patients could avoid having surgical meniscus repairs if they undertook a new form of exercise therapy instead, the BMJ (formerly the British Medical Journal) reports.

Menisci are the cartilaginous discs within the knee joint, and injuries to them can be painful when running or exercising, or even getting about your day-to-day tasks.

According to the findings of a new study, led by Nina Jullum Kise – a PhD candidate and senior consultant at the Department of Orthopaedic Surgery in Martina Hansen´s Hospital Bærum, Norway – exercise can be just as effective for treating these injuries as surgery.

As the report´s Introduction explains, as many as 300 in 100,000 people undergo arthroscopic partial meniscectomy in the Western world each year. In most cases, the meniscal tears are degenerative and thought to be the first signs of osteoarthritis.

The objective of the study was “To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears.”

Some 140 patients with meniscus injuries across Norway and Denmark took part in the study, drawing lots for treatment through either exercise or surgery. The study was the first of its kind to compare cases in this way.

The participants ranged from age 35.7-59.9, with a mean age of 49.5. Their meniscal tears had been confirmed by magnetic resonance imaging, but the majority (96%) had no radiographic evidence of osteoarthritis.

After two years, researchers found that both groups had reduced symptoms and improved functioning, with no difference between the two groups.

In fact, those in the exercise control group had developed greater muscle strength, whereas there was no additional benefit for those who had undergone surgery.

With a meniscus operation costing at least 16,000 Norwegian kroner, in addition to workplace absence, it is thought that the exercise therapy programme – where patients visit a physiotherapist 2-3 times per week for 12 weeks – could produce significant cost savings.

The report concluded that the results “should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option.”

https://www.med.uio.no/helsam/english/research/news-and-events/news/2016/surgical-meniscus-repairs-unnecessary.html

http://www.bmj.com/content/354/bmj.i3740