You might not want to rush into knee surgery. Physical therapy can be just as good for a common injury and at far less cost and risk, the most rigorous study to compare these treatments concludes.
Therapy didn't always help, and some people wound up having surgery for the problem, called a torn meniscus. But those who stuck with therapy had improved as much, six months and one year later, as those who were given arthroscopic surgery right away, researchers found.
"Both are very good choices. It would be quite reasonable to try physical therapy first, because the chances are quite good that you'll do quite well," said one study leader, Dr. Jeffrey Katz, a joint specialist at Brigham and Women's Hospital and Harvard Medical School.
He was to discuss the study Tuesday at an American Academy of Orthopaedic Surgeons conference in Chicago. Results were published online by the New England Journal of Medicine.
A meniscus is one of the crescent-shaped cartilage discs that cushion the knee. About one-third of people over 50 have a tear in one, and arthritis makes this more likely. Usually the tear doesn't cause symptoms, but it can be painful.
When that happens, it's tough to tell if the pain is from the tear or the arthritis, or whether surgery is needed or will help. Nearly half a million surgeries for torn meniscus are done each year in the U.S.
Surgery costs about $5,000, compared with $1,000 to $2,000 for a typical course of therapy, Katz said.
One study participant, Bob O'Keefe, 68, of suburban Boston, was glad to avoid surgery for his meniscus injury three years ago.
"I felt better within two weeks" on physical therapy, he said.