As physical therapists we often hear our patients raise the question about choosing physical therapy or surgery. People are in pain, they learn that they have some level of tissue damage that could be repaired with surgery, but the surgery isn’t always absolutely necessary. Surgery is risky, expensive, and often leaves you unable to move functionally for awhile, perhaps even prevents you from working for a few weeks. Physical therapy is time consuming, requires dedication and effort, and does it work in preventing the need for surgery?
A research study recently addressed this dilemma with regards to meniscus tears and osteoarthritis of the knee. The study, published March 19th, in the New England Journal of Medicine, included data on 351 subjects from researchers at 7 universities and orthopedic surgery centers in different cities around the world. The results showed no significant differences in functional improvement after six months between patients who underwent surgery with postoperative physical therapy and those who received standardized physical therapy alone.
As recently reported by the APTA, this study demonstrates what physical therapists have long known,” explained APTA President Paul A. Rockar Jr, PT, DPT, MS. “Surgery may not always be the best first course of action. A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. This study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.”
Physical therapist and APTA member Mary Ann Wilmarth, PT, DPT, MS, OCS, MTC, Cert MDT, 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.”
Read the full APTA report by clicking here.
Journal article: Jeffrey N. Katz, Robert H. Brophy, Christine E. Chaisson, Leigh de Chaves, Brian J. Cole, Diane L. Dahm, Laurel A. Donnell-Fink, Ali Guermazi, Amanda K. Haas, Morgan H. Jones, Bruce A. Levy, Lisa A. Mandl, Scott D. Martin, Robert G. Marx, Anthony Miniaci, Matthew J. Matava, Joseph Palmisano, Emily K. Reinke, Brian E. Richardson, Benjamin N. Rome, Clare E. Safran-Norton, Debra J. Skoniecki, Daniel H. Solomon, Matthew V. Smith, Kurt P. Spindler, Michael J. Stuart, John Wright, Rick W. Wright, Elena Losina. Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. New England Journal of Medicine, 2013; : 130318220107009 DOI: 10.1056/NEJMoa1301408.