Surgery vs Physical Therapy for MENISCUS TEARS Which One Wins?

By dpope2020

November 8, 2024

all about meniscus surgery, dan pope, dr. david middaugh, el paso manual physical therapy, fitness pain free, fitnesspainfree, knee injury, knee meniscus surgery, knee pain, knee surgery, meniscus, meniscus exercises, meniscus injury, meniscus rehab exercises, meniscus repair, meniscus surgery, meniscus surgery decoded, meniscus tear, meniscus tear exercises, meniscus tear rehab, new meniscus surgery, orthopedics, physical therapy, torn meniscus, torn meniscus exercises

Surgery vs Physical Therapy for MENISCUS TEARS Which One Wins?

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In today's video we go over Surgery vs Physical Therapy for MENISCUS TEARS Which One Wins? FPF Show Episode 150

  • 0:00 Introduction
  • 0:48 What are the surgical options for meniscus surgery? (repair, meniscectomy, transplant)
  • 2:05 BJSM clinical practice guideline recommendations for meniscus surgery in degenerative meniscus tears
  • 5:42 Is meniscectomy surgery superior to physical therapy treatment for degenerative meniscus tears?
  • 10:10 Do all patients with degenerative meniscus tears have success with physical therapy or do some go on to have surgery?
  • 14:43 How does a SHAM (fake) meniscectomy surgery compare to a real surgery (meniscectomy)?
  • 19:39 Does meniscectomy outperform physical therapy in ACUTE TRAUMATIC meniscus tears?
  • 23:29 Does meniscectomy OR repair outperform physical therapy in traumatic meniscus tears? (1-2 year outcomes)
  • 31:59 Do meniscus tears heal on their own? (Spontaneous healing rates - Non-operatively)
  • 40:57 Do mechanical symptoms improve more with physical therapy or surgery in degenerative meniscal tears?
  • 44:44 Do mechanical symptoms improve more with physical therapy or surgery in acute traumatic tears?
  • 49:51 Which patients are the best candidates for physical therapy management?
  • 50:58 Which patients are best candidates for meniscus surgery (Acute Tears)?
  • 53:46 Which patients are best candidates for meniscus surgery (Degenerative Tears)?
  • 54:00 How long should patients perform physical therapy and wait before considering surgery?

Surgery!  No, wait, Physical Therapy!,

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Damsted C, Skou ST, Hölmich P, Lind M, Varnum C, Jensen HP, Hansen MS, Thorlund JB. Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults-An Exploratory Analysis From the DREAM Trial. J Orthop Sports Phys Ther. 2024 May;54(5):340-349. doi: 10.2519/jospt.2024.12245. PMID: 38385220.

  2. Sedgwick MJ, Saunders C, Getgood AMJ. Systematic Review and Meta-analysis of Clinical Outcomes Following Meniscus Repair in Patients 40 Years and Older. Orthop J Sports Med. 2024 Aug 8;12(8):23259671241258974. doi: 10.1177/23259671241258974. PMID: 39131093; PMCID: PMC11311169.

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  4. Siemieniuk RAC, Harris IA, Agoritsas T, et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: A clinical practice guideline. BMJ 2017;357:j1982

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  10. Damsted C, Skou ST, Hölmich P, Lind M, Varnum C, Jensen HP, Hansen MS, Thorlund JB. Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults-An Exploratory Analysis From the DREAM Trial. J Orthop Sports Phys Ther. 2024 May;54(5):340-349. doi: 10.2519/jospt.2024.12245. PMID: 38385220.

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  12. Marigi EM, Davies MR, Marx RG, Rodeo SA, Williams RJ 3rd. Meniscus Tears in Elite Athletes: Treatment Considerations, Clinical Outcomes, and Return to Play. Curr Rev Musculoskelet Med. 2024 Aug;17(8):313-320. doi: 10.1007/s12178-024-09907-w. Epub 2024 Jun 4. PMID: 38833135; PMCID: PMC11219605.

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  14. Beaufils P, Becker R, Kopf S, Matthieu O, Pujol N. The knee meniscus: management of traumatic tears and degenerative lesions. EFORT Open Rev. 2017;2(5):195‐203. Published 2017 May 11. doi:10.1302/2058-5241.2.160056

  15. van der Graaff SJA, Eijgenraam SM, Meuffels DE, et alArthroscopic partial meniscectomy versus physical therapy for traumatic meniscal tears in a young study population: a randomised controlled trialBritish Journal of Sports Medicine 2022;56:870-876

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Images:

  1. Medial Meniscus Source: https://commons.wikimedia.org/wiki/File:Medial_Meniscus_Injury.png Attribution: BruceBlaus / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0) Edited by fitness pain free LLC