Physical therapy can be as effective as surgery for torn meniscus

You may have heard that a clinical study recently published by The New England Journal of Medicine   found that physical therapy can be as effective as knee surgery for treating patients with a torn meniscus. The following physical therapy protocol was used in the study and is taken from The New England Journal of Medicine:

Physical Therapy

The physical-therapy protocol was developed by a team of experienced physical therapists. The protocol was based on literature supporting the effectiveness of land-based, individualized physical therapy with progressive home exercise for patients with knee osteoarthritis. The three-stage structured program was designed to address inflammation, range of motion, concentric and eccentric muscle strength, muscle-length restrictions, aerobic conditioning (e.g., with the use of a bicycle, elliptical machine, or treadmill), functional mobility, and proprioception and balance. Details of the physical-therapy program are described in Table Two in the Supplementary Appendix. Criteria for advancing from stage I to II and from stage II to III included the level of self-reported pain, observed strength, range of knee motion, knee effusion, and functional mobility. At each stage, it was recommended that the patient attend physical-therapy sessions once or twice weekly and perform exercises at home. Patients progressed at their own pace; the duration of participation varied depending on the pace of improvement. Generally, the program lasted about 6 weeks. 

Nearly 500,000 people undergo surgery each year to treat a torn meniscus. Many of these patients could seek physical therapy instead of surgery.

  • How do you treat these patients differently from when you see them post-op a meniscectomy?
  • If you use a similar protocol to that in the study have you experienced any problems with it?
  • Do you have any suggestions on how to generate more referrals for this condition?
  • Is there a need for education and training on treating patients with this condition?

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