Effect of Early Surgery vs Physical Therapy on Knee Function Among Patients with Nonobstructive Meniscal Tears

By, Barbara Reuven, PT

Many patients that I see with the diagnosis of a meniscal tear have the same question, “should I undergo surgery?” Every knee has two menisci which act as shock absorbers for the knee. The meniscus presence is very important for decreasing the amount of osteoarthritis that is developed in this joint. There have been numerous studies which demonstrate that, in some cases, surgery may not be necessary and the ailment may improve with physical therapy alone. The advantage of not having surgery includes decreasing the risk of infections and preserving the knee's integrity.

In a recent study done by the Journal of the American Medical Association, it was found that patients with meniscal tears which are non-obstructive, in other words, that do not impede the knees range of motion, can improve with physical therapy alone. It was suggested by this study that physical therapy should be done as the initial intervention for this injury, as to preserve the natural shock absorber of this joint,

Surgery should be pursued if the following occurs:

 Persistent knee pain that remains after 3 to 4 weeks of rehab
 Loss of knee mobility that is not restored with PT
 Difficulty walking, rising from sitting, or climbing stairs
 Persistent knee swelling