New Study Shows Rehab Best for Meniscus Tears
Aug 6, 2016
By Dr. Josh Bross
Elite Chiropractic & Sport located in Columbia; Howard County, happily serving all of Maryland
Written by Dr. Stephen Knoyer, DC
Knee injuries are very common in sports, especially ones that have running, sprinting and/or fast stopping with pivoting. As people continue to play, small tears can occur in the meniscus, and then develop into larger tears that can become painful. Injuries can take time to heal, and if the process isn’t fast enough for the individual, they get inpatient and seek invasive options. I will often say to patients it is much easier to hurt the body than heal it. People that experience these mensicus tears often believe that surgery is needed, when often times it is not.
A recent study out of Norway had very interesting result to report about meniscus tears. Outside of large traumas to the knee that require surgery, rehabilitation is the best and first choice. This study followed a population that participated in a 12 week rehabilitation program for strengthening the muscle around the knee. Then compared them to another population that had Arthroscopy for the injury and found no difference between the two.
What does this mean, what is the take away message from this article? Outside of large traumas and severely reduced function because of an injury, (often times catching or locking of the knee is common with a specific type of meniscus tear) rehabilitation for the injured area should be done first. This is method is being implemented more with all types of injuries. A well designed rehabilitation plan should be followed prior to any surgeries, and then if no documentable change is noted or they become worse during treatment, then they are a surgical candidate. Another great fact from the article is they offered patients surgery after the exercise program was completed if they were not satisfied with the end result. The people that chose the surgery had no change after.
A second report noted different studies about the effectiveness of surgery and whether it helped the original complaint. It noted that not everyone improves after surgery and that placebo is the reason patients improve. One thing that surprised me was regardless of the evidence, procedures were still being done. My favorite quote from this was, “I personally think the operation should not be mentioned,” Dr. Guyatt says, adding that in his opinion the studies indicate the pain relief after surgery is a placebo effect. But if a doctor says anything, Dr. Guyatt suggests saying this: “We have randomized clinical trials that produce the highest quality of evidence. They strongly suggest that the procedure is next to useless. If there is any benefit, it is very small and there are downsides, expense and potential complications.” Follow the links below for more information.
To get treatment for any meniscal knee pain, or other various aches and pain, schedule an appointment now!