The meniscus are found on the inside and outside of each knee. They provide cushion and stability between the two bones joining at the knee. A meniscal tear is one of the more common knee injuries and can occur with trauma such as compression and rotation (ex. cutting) or occur with aging. The latter tear, called a degenerative meniscal tear, is most commonly treated with Physical Therapy. Evidence on this category of meniscal tear shows no difference in treatment outcomes between Physical Therapy or surgery.
Evidence continues to grow that many acute tears in younger patients also do not require surgery. Some patients in our Boulder Physical Therapy and Lafayette Physical Therapy clinics ask if their mensical tear will worsen without surgical intervention. Similar to other injured structures in the body such as a rotator cuff tear the research is leading us to answer not necessarily. A recent longitudinal study sought to answer the question of a worsening meniscal tear with Physical Therapy vs. surgery.
Clausen and colleagues published their findings on the difference in reported outcomes and meniscal structural tearing between patients treated surgically or conservatively with exercise (Br J Sp Med. 2024). Authors performed a secondary analysis on their prior randomized controlled trial for patients with meniscal tears. 121 patients (ages 18-40) with a MRI confirmed meniscal tear were randomized to either surgery or conservative care including Physical Therapy. Patients were followed up for up to 2 years after randomization. Authors reported structural worsening on MRI was noted in 9 patients but not significant differences were found between surgical or conservative groups. Further, no differences were noted on other clinical measures. Although some patients with a meniscal tear require surgery, this study supports the utilization of Physical Therapy for the treatment first to determine the most appropriate treatment for each patient.