Research news: May 2013
N Engl J Med2013; doi:10.1056/NEJMoa1301408
Meniscal tears are common in older adults with mild osteoarthritis of the knee, and most are managed surgically. An initial course of physiotherapy can work just as well, according to a trial from the US. Most people assigned physiotherapy avoided surgery altogether.
Participants had an arthroscopic partial meniscectomy (n=161) or initial physiotherapy (n=169) with the option of surgery later. Both groups had comparable improvements in function over six months and 12 months (20.9 v 18.5 point improvement in WOMAC score over six months; mean difference 2.4 points, 95% CI −1.8 to 6.5). Just over a third of the physiotherapy group eventually needed surgery, usually within six months (51/169; 30%). Adults who had surgery earlier and later had similar symptom scores one year after randomisation.
The new trial adds to growing evidence that physiotherapy is a reasonable first option for older people with meniscal tears and