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"&lt;p&gt;&lt;/p&gt;&lt;p&gt;Middle-aged adults who are diagnosed with a degenerative&amp;nbsp;meniscal&amp;nbsp;tear\u2014a common injury caused by wear and tear of the knee joint\u2014should first try physical therapy, recommends new&amp;nbsp;research&amp;nbsp;published this week in&amp;nbsp;&lt;em&gt;The&amp;nbsp;BMJ&lt;/em&gt;. Supervised exercise is just as effective as surgery, study authors say, with less risk to the patient and a lower price tag to society as a whole.\r\n\r\n&lt;/p&gt;&lt;p&gt;An estimated two million people have arthroscopic knee surgery (also known as minimally-invasive or \u201Ckeyhole\u201D surgery) each year, at a cost of several billion dollars. But increasingly, studies have shown that these procedures have little benefit to most patients.\r\n\r\n&lt;/p&gt;&lt;p&gt;So researchers in Denmark and Norway organized a clinical trial to compare treatment with surgery versus treatment with physical therapy. Out of&amp;nbsp;140 adults with degenerative&amp;nbsp;meniscal&amp;nbsp;tears, half received arthroscopic surgery and were given exercises to perform at home; the other&amp;nbsp;half were prescribed 12 weeks of supervised exercise sessions, two to three times a week.\r\n\r\n&lt;/p&gt;&lt;p&gt;Three months later, the second&amp;nbsp;group actually scored higher on tests of thigh&amp;nbsp;muscle strength than the surgery group. After two years, improvement in both groups was equal: The participants&amp;nbsp;reported similar progression in terms of pain, ability to play sports and participate in recreation, and knee-related quality of life. And although 13 patients in the physical therapy group had eventually decided to undergo surgery, the procedure didn\u2019t end up providing them any additional benefits.\r\n\r\n&lt;/p&gt;&lt;p&gt;&lt;strong&gt;\u2022&amp;nbsp;How to avoid knee pain&lt;/strong&gt;\r\n\r\n&lt;/p&gt;&lt;p&gt;\u201CIn general, non-surgical treatment is preferable for the patients, because all surgical treatment includes a risk for complications,\u201D says co-author Nina&amp;nbsp;Jullum&amp;nbsp;Kise, MD, an orthopedic surgeon at&amp;nbsp;Martina&amp;nbsp;Hansens&amp;nbsp;Hospital in Norway. \u201CIf it is possible to choose a treatment option that is non-surgical, that is the way to go.\u201D\r\n\r\n&lt;/p&gt;&lt;p&gt;Dr. Kise&amp;nbsp;says that some doctors have begun to recommend exercise over surgery for common knee ailments, thanks to previous studies with similar findings. \u201CBut we have work to do here,\u201D she adds. \u201CThis will not change overnight.\u201D\r\n\r\n&lt;/p&gt;&lt;p&gt;She also points out that her study was done on adults with degenerative&amp;nbsp;meniscal&amp;nbsp;tears\u2014not traumatic&amp;nbsp;meniscal&amp;nbsp;tears, which often occur in younger people and are caused by sports injuries or accidents. Traumatic tears can restrict the knee\u2019s range of motion, and surgical repair should always be considered in these cases.\r\n\r\n&lt;/p&gt;&lt;p&gt;\u2022 &lt;strong&gt;Cricks and cracks: Why back injuries are on the rise in MLB&lt;/strong&gt;\r\n\r\n&lt;/p&gt;&lt;p&gt;For degenerative tears, repair of the meniscus is not possible. The only surgical option is resection\u2014cutting away sections of tissue\u2014which can lead to further wearing down of the knee\u2019s cartilage and, eventually, to osteoarthritis.\r\n\r\n&lt;/p&gt;&lt;p&gt;If a patient is diagnosed with this type of tear and a doctor recommends surgery, Dr.&amp;nbsp;Kise&amp;nbsp;suggests&amp;nbsp;getting a second opinion. \u201CI would say that is the wrong treatment and bad practice,\u201D she says. She recommends seeing a physical therapist at least once a week to get proper instruction, and doing the prescribed exercises two to three times a week total&amp;nbsp;for three months. If you still have pain, she says, then you might consider an operation.\r\n\r\n&lt;/p&gt;&lt;p&gt;&lt;strong&gt;\u2022 5 joint-friendly foods, and foods that may hurt them&lt;/strong&gt;\r\n\r\n&lt;/p&gt;&lt;p&gt;While surgery may seem like a quick-fix, Dr.&amp;nbsp;Kise&amp;nbsp;adds, it\u2019s not the best solution in the long run. \u201CPeople think exercise therapy is time-consuming, expensive, it's difficult to take time off from work, and so on,\u201D she says. \u201CI try to explain to them how important it is to save the meniscus, to reduce risk for osteoarthritis over longer time, and that they can save the meniscus if they spend some time and money [on physical therapy] here and now.\u201D\r\n\r\n&lt;/p&gt;&lt;p&gt;&lt;em&gt;This&amp;nbsp;article&amp;nbsp;was originally published on Health.com.&lt;/em&gt;\r\n&lt;/p&gt;"^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.si.com/edge/2016/07/26/physical-therapy-exercises-meniscus-tear-knee-injuries-surgery>