Physical therapy is often as effective as knee surgery

[rpm]

Physical therapy is often as effective as knee surgery when treating patients with tears to the meniscus or arthritis, according to a clinical study published on Tuesday.

In the study, half of 351 participants aged over 45 suffering with meniscus tears or osteoarthritis were randomly selected to undergo knee arthroscopy with the other half getting several weeks of physical therapy.

After six and 12 months, the knee function of participants was assessed and showed similar levels of improvement, according to findings published in the New England Journal of Medicine.

The lead author of the research, Jeffrey Katz, Professor of Medicine and Orthopedic Surgery at Harvard University, said the study suggested there was "no single 'best' treatment."

"Since both the patients who received physical therapy and those who received surgery had similar and considerable improvements in function and pain, our research shows ... there is no single 'best' treatment," Katz said.

"Patients who wish to avoid surgery can be reassured that physical therapy is a reasonable option, although they should recognize that not everyone will improve with physical therapy alone."

He noted that one third of patients who received physical therapy ultimately elected to have surgery, often because their conditions had not improved with therapy alone.

More than 450,000 arthroscopies are performed each year in the United States, commonly for treating meniscus tears.

The cost of the operation is around $4,500 compared to around $2,000 for a course of physical therapy.

 

[flarkit]

Well that's dandy, I had an arthroscopy *and* the physio last year and it's clear that you do need the physio. A surgical procedure along cannot recondition the muscle

 

[Hosehead]

I fail to see how Physiotherapy for OA of the knee works on a mechanical problem , when muscles are not involved since OA is a degenerative bone condition. Surgery like arthroscopy can scrape the joint, debride and remove bits of cartilage but it works for some and not others. I am surprised the study did not mention the relief brought by a course of hyaluronan injections which is basically like WD-40 for bone on bone and allows many sufferers total pain relief for up to 6 months.It's made from Chicken Combs and it's like injecting jelly into the knee joint- excruciatingly, but fleetingly painful and no mention of Cox 2 inhibitors like Celebrex.
I'd like to read this study because it has the hallmarks of the Physiotherapy Lobby and funding written all over it.
In any case the most important quote in the whole article for me was

The lead author of the research, Jeffrey Katz, Professor of Medicine and Orthopedic Surgery at Harvard University, said the study suggested there was "no single 'best' treatment.

 

[rubytox]

I 100% disagree with this article.
Physiotherapy can, in fact, make the problem a lot worse.

 

[HavocXphere]

I 100% disagree with this article.
Physiotherapy can, in fact, make the problem a lot worse.

+1 Its likely to create the wrong impression.

Exercise under the wrong conditions is a really bad idea.

Leave it up to the pros to decide what course of action is best.

I had an arthoscopy...and a physio...turns out the problem is something neither the surgeon or the physio can fix. :/

 

[Hosehead]

I had an arthoscopy...and a physio...turns out the problem is something neither the surgeon or the physio can fix. :/

Oh don't worry there's Pharmacists who can get it sorted.

 

[Tinuva]

I fail to see how Physiotherapy for OA of the knee works on a mechanical problem , when muscles are not involved since OA is a degenerative bone condition. Surgery like arthroscopy can scrape the joint, debride and remove bits of cartilage but it works for some and not others. I am surprised the study did not mention the relief brought by a course of hyaluronan injections which is basically like WD-40 for bone on bone and allows many sufferers total pain relief for up to 6 months.It's made from Chicken Combs and it's like injecting jelly into the knee joint- excruciatingly, but fleetingly painful and no mention of Cox 2 inhibitors like Celebrex.
I'd like to read this study because it has the hallmarks of the Physiotherapy Lobby and funding written all over it.
In any case the most important quote in the whole article for me was

Strength training doesn't only work on muscles like most people believe. I have seen many cases, where people had knee problems, or other problems with the bone or ligaments, and whilst doing strength training of the muscles around the affected area caused the ligaments to strengthen, and the bones to grow more dense. I believe that to be the reason why physio could be as successful as surgery...in some cases, not all cases.

Here is motivational example: http://www.youtube.com/watch?v=qX9FSZJu448

 

[goofball]

Physical therapy is often as effective as knee surgery when treating patients with tears to the meniscus or arthritis, according to a clinical study published on Tuesday.

In the study, half of 351 participants aged over 45 suffering with meniscus tears or osteoarthritis were randomly selected to undergo knee arthroscopy with the other half getting several weeks of physical therapy.

After six and 12 months, the knee function of participants was assessed and showed similar levels of improvement, according to findings published in the New England Journal of Medicine.

The lead author of the research, Jeffrey Katz, Professor of Medicine and Orthopedic Surgery at Harvard University, said the study suggested there was "no single 'best' treatment."

"Since both the patients who received physical therapy and those who received surgery had similar and considerable improvements in function and pain, our research shows ... there is no single 'best' treatment," Katz said.

"Patients who wish to avoid surgery can be reassured that physical therapy is a reasonable option, although they should recognize that not everyone will improve with physical therapy alone."

He noted that one third of patients who received physical therapy ultimately elected to have surgery, often because their conditions had not improved with therapy alone.

More than 450,000 arthroscopies are performed each year in the United States, commonly for treating meniscus tears.

The cost of the operation is around $4,500 compared to around $2,000 for a course of physical therapy.

Where is the link to the source? Whats going on here on MYBB?? No need to give sources anymore?

 

[rubytox]

Strength training doesn't only work on muscles like most people believe. I have seen many cases, where people had knee problems, or other problems with the bone or ligaments, and whilst doing strength training of the muscles around the affected area caused the ligaments to strengthen, and the bones to grow more dense. I believe that to be the reason why physio could be as successful as surgery...in some cases, not all cases.

Here is motivational example: http://www.youtube.com/watch?v=qX9FSZJu448

Did you see X-rays pre and post physio?

I used to do a lot of running and hiking. When my knee started giving problems, I used painkillers. As soon as I ran out of painkillers, I had to get to pharmacy ASAP.
By the time I realised that I was addicted to pain killers, I knew that it was time to visit the doctor. X-rays showed that there was nothing wrong ... so off to physio. This carried on for about 3 years. Sometimes the pain was unbearable and then at other times it was just okay. Eventually I went to another doctor for a 2nd opinion and he suggested an MRI which clearly showed the problem. The op was painless. It took a bit of time to heal but I started walking the dogs on the beach every day. I don't remember when the discomfort disappeared. That operation was worth every penny because I am free of pain and daily pain medication.

 

[Hosehead]

Oh sod it. The problem is getting past the pain barrier in order to exercise. If it's not a physio its an Othotic and a massively expensive knee brace which looks like terminator's minus the firepower. Then there's foot inserts. Injections, pills, potions.
I think it's better to just get a brand new knee. With the new ones today apparently you can do just about anything.
*Picks up phone to call hospital's spare parts division*

 

[ToxicBunny]

I know its not related to the knee issue, but my dad has massive shoulder problems.

He was recommended surgery by 2 doctors, each costing stupid amounts of money that he couldn't afford and the surgery was not guaranteed to work (had like a 60% success rate). Our family GP recommended that he go and see a specific person who then suggested instead of surgery he go for physio once a week for awhile, and the physio gave my dad some exercises. A year down the line, my dad no longer "needs" surgery, his shoulder is pretty much back to where it was 10 years ago and he has full motion etc in it.

So yes, physio CAN be as effective, if not more so in some circumstances, than surgery.

 

[rubytox]

I know its not related to the knee issue, but my dad has massive shoulder problems.

He was recommended surgery by 2 doctors, each costing stupid amounts of money that he couldn't afford and the surgery was not guaranteed to work (had like a 60% success rate). Our family GP recommended that he go and see a specific person who then suggested instead of surgery he go for physio once a week for awhile, and the physio gave my dad some exercises. A year down the line, my dad no longer "needs" surgery, his shoulder is pretty much back to where it was 10 years ago and he has full motion etc in it.

So yes, physio CAN be as effective, if not more so in some circumstances, than surgery.

I'm glad that things worked out well for your dad. Surgery should always be the last option.

In my case, I tried to avoid surgery and paid a fortune to a physiotherapist. The pain got progressively worse over a long period of time. The only thing that really helped and lasted for a couple of days, was Cortisone injections inside the knee. It was gory but compared to the pain in my knee, a song in the park.

The orthopaedic surgeon who has done the op, told me that in his opinion, physiotherapy made my problem a whole lot worse, hence the debilitating pain. Before the op, there were days when I had to hobble around with my insides screaming PAINKILLERS PLEASE! Climbing stairs became a nightmare.

Have anyone else have/had knee problems? Does or did physio work for you?