THE NEW ENGLAND JOURNAL OF MEDICINE: Physical Therapy or Arthroscopic Knee Surgery?
A new study questioning the usefulness of arthroscopic surgery for osteoarthritis of the knee should encourage patients to consider physical therapy as an effective non-surgical option, according to the American Physical Therapy Association (APTA). The study was published in the New England Journal of Medicine (NEJM).
- The study found that physical therapy, combined with comprehensive medical management, is just as effective at relieving the pain and stiffness of moderate to severe osteoarthritis of the knee as surgery. There were no differences in functional improvement in patients who had surgery or patients that received physical therapy.
The surgery utilized in the study was a debridement, to clean the joint; it was not surgery to fix a problem, such as a meniscus tear.
“This study offers hope and encouragement to persons with osteoarthritis who would like to avoid the pain and emotional toll of surgery,” said APTA President R Scott Ward, PT, PhD. “Too often, the first line of defense is surgery when it need not always be. Physical therapy can be equally effective and should be considered by not only patients themselves, but also the primary care doctors and orthopedists who are treating them.”
According to physical therapist Christopher M Powers, PhD, PT, director of the Biokinesiology program and co-director of the Musculoskeletal Biomechanics Research Lab at the University of Southern California Division of Biokinesiology & Physical Therapy, “Many times knee pain is associated with abnormal movement patterns that cause increased stress on the joint. Arthroscopic surgery does little to correct the dynamic factors that may be contributing to knee pain and pathology. These findings reinforce the need for a comprehensive treatment approach for such patients.”
Health care providers are being encouraged to reconsider what treatments are necessary in knee injuries. Although this is improving, it is up to the patient to decide what is right for them. So what would you choose – Physical therapy or arthroscopic knee surgery?
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