A new study suggests that surgery may be the best option for a torn meniscus in the knee. But is it the right treatment for you?
For many orthopedic injuries, conservative treatment methods such as physical therapy are recommended, especially as the first step of recovery. However, if conservative approaches fail to bring about relief, or if the trauma is serious enough, surgical intervention may be the most effective solution.
Recently, a study published in Arthritis Care and Research compared physical therapy to surgery as a treatment for a meniscus tear in the knee. The report concluded that patients undergoing an arthroscopic partial meniscectomy (APM) showed more significant improvement in joint health and stability. While both physical therapy and surgery strengthened the knee, follow-up MRIs after 18 months indicated that arthroscopic surgery patients displayed better results on a number of markers.
Does this mean all meniscus tears should be treated with surgery? Not necessarily. Much depends on the cause and severity of the rupture.
WHAT IS A MENISCUS TEAR?
Two C-shaped wedges of cartilage known as the menisci cushion the knee joint. A sudden tear or gradual deterioration can lead to severe knee pain, swelling, tenderness, and a restricted range of motion. Some patients may also feel a “popping” in the knee and a persistent locking of the joint, which make it difficult to put weight on the knee.
Because there are two menisci, the tear can happen in two areas. A meniscus rupture typically occurs in the inside part of the knee (medial) or the outside section of the joint (lateral). The tear may vertical, horizontal, or exhibit multiple breaks.
Although athletic activities that involve repeated planting and pivoting of the feet put knee cartilage at greater risk of a rupture, the majority of meniscus tears result from a degenerative condition like arthritis. In fact, 73% develop in people between the ages of 45 and 84.
MENISCUS TEAR TREATMENTS
After a physical examination of the knee, an X-ray or MRI is used to confirm the diagnosis of a meniscus tear. Next, your doctor will suggest treatment options to heal the rupture. For older, less active patients or those with minor tears, physical therapy is an effective way to reduce pain and swelling. If arthritis caused the tear, icing, rest, compression, and elevation of the damaged knee can restore normal function within weeks.
However, more significant tears usually require arthroscopic surgery. To begin, a surgeon creates two small incisions and reconstructs the cartilage in the knee. An arthroscopic meniscectomy trims away the damaged cartilage and smooths the remaining meniscus so the tear cannot spread. In other cases, the meniscus is repaired, allowing it to cushion the knee bones while preventing premature arthritis.
After surgery, patients can resume their daily activities within two to three days, although they may have to use a cane or wear a brace initially. Patients should also participate in physical therapy to build strength and restore a full range of motion to their joints.
SHOULD YOU HAVE SURGERY FOR A MENISCUS TEAR?
Though the recent study suggests arthroscopic surgery is more effective than physical therapy in treating most meniscus tears, the recommended treatment option varies according to each patient’s situation. Depending on your age and the severity of your injury, your knee may not require an operation at all.
The orthopedic surgeons and physical therapists at New York Bone & Joint Specialists will expertly diagnose your meniscus tear, then customize a unique treatment plan to get you moving pain-free again. Book an appointment at one of our convenient NYC locations today.