Many people read the recent article in the Washington Post titled “Knee repair? Study finds physical therapy as good as surgery for torn cartilage, arthritis” and have been asking us about what we think about the study. To me it was not surprising considering previous studies had already found there was no benefit to surgery with mild to severe osteoarthritis.
There are some points about the study that should be pointed out however. This was a study of surgery and PT vs. PT only. So if you need PT either way why consider the surgery as a first option? The way I see it is that there are surgical complications (albeit rare) that you should not risk if there is no additional benefit for surgery. The average time for those who completed therapy was 6 weeks (8.4 visits). A minority of the PT only patients still needed surgery, but if you came to us you wouldn’t have to go to many PT sessions before we would refer you to an orthopedist if necessary. As the time frame and visits suggest you should make a rather rapid recovery with physical therapy.
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.”
Physical therapy is so successful because it is aimed at preventing the causes of the pain. Mary Ann Wilmarth the chief of physical therapy at Harvard University, said, “Physical therapists are experts in improving mobility and restoring motion. The individualized treatment approach is very important in the early phases of rehabilitation in order to achieve desired functional outcomes and avoid setbacks or complications.”
Are there reasons to get surgery for meniscus and arthritis pain? Yes, physical therapy will not always work. However for a majority of patients this study found there is no benefit to having surgery. If you have knee pain and want answers, call or email us to ask if PT is right for you.
Jamie Bovay, DPT, CSCS