If you have chronic knee pain, “double down on efforts for things we know work—for example, weight loss and physical therapy,” he advise.
Dr. Joseph Bosco, vice-chair at NYU Langone Orthopedics in New York City, tells Reuters Health, “In general, I agree with the findings and support most of the conclusions.”
“The only issue is that in the study with the strongest evidence, the operative group did not do physical therapy,” he says by email. “That is not consistent with how we treat our patients. Almost all patients get physical therapy following knee arthroscopies.”
“Cortisone injections, physical therapy and anti-inflammatory medications work as well or better than surgery for most degenerative meniscal tears,” says Bosco, who was not involved in developing the guidelines.
However, he adds, a small group of people “who [also] have mechanical symptoms, localized pain and acute onset of pain will benefit, so a blanket recommendation against all surgery for degenerative meniscal tears is not appropriate.”
Reference
- Siemieniuk RAC, Harris IA, Agoritsas T, et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: A clinical practice guideline. BMJ. 2017 May 10;357:j1982. doi: 10.1136/bmj.j1982.
