Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Is surgery the only option for meniscal tear and osteoarthritis?

19.03.2013
New research finds that for a number of patients physical therapy provides similar improvements in physical function and pain

Many middle age and older adults have disabling knee pain due to a tear in the meniscus, an important supporting structure in the knee that is often damaged in patients with underlying knee osteoarthritis.

In the United States, more than 450,000 arthroscopic meniscal surgeries are performed each year to treat meniscal tears. However, there is little data available to clinicians who must decide with their patients whether it is best to treat tears with surgery or with physical therapy.

Now, new research from Brigham and Women's Hospital (BWH), suggests that physical therapy (PT) may prove just as effective as surgery for some patients. These findings are presented at the annual meeting of the American Academy of Orthopedic Surgeons and simultaneously published online in the New England Journal of Medicine.

"Since both the patients who received physical therapy and those who received surgery had similar and considerable improvements in function and pain, our research shows that there is no single "best" treatment," said Jeffrey N. Katz, MD, MSc, principal investigator for the trial. "Patients who wish to avoid surgery can be reassured that physical therapy is a reasonable option, although they should recognize that not everyone will improve with physical therapy alone.
In this study, one third of patients who received physical therapy ultimately chose to have surgery, often because they did not improve with PT," added Katz, who is director of the Orthopedic and Arthritis Center for Outcomes Research at BWH and Professor of Medicine and Orthopedic Surgery at Harvard Medical School.

These findings are from the MeTeOR (Meniscal Tear in Osteoarthritis Research) Trial, a multicenter study designed by a research team at BWH that involved 351 patients who were over 45 years old with knee pain, meniscal tear and knee osteoarthritis. The patients were randomized to receive arthroscopic meniscal surgery or physical therapy. Those subjects assigned to the physical therapy arm had the opportunity to undergo surgery later in the course of the trial if they wished. Researchers assessed their improvement in functional status using standardized functional status scores after six and twelve months.

The researchers report that subjects assigned to physical therapy and those assigned to surgery both had substantial and similar improvements in functional status. However, researchers also note that these results were achieved in part because one-third of subjects assigned to the physical therapy arm elected to undergo surgery over the course of the study. The remaining two-thirds of patients in the physical therapy group did achieve similar improvements in pain and physical function compared to the surgical group, but without undergoing surgery.

"We hope these findings will help physicians and their patients with knee pain, meniscal tear and osteoarthritis to discuss the likely outcomes of surgery and physical therapy and make informed treatment decisions," said senior author, Elena Losina, PhD, co-director of the Orthopaedic and Arthritis Center for Outcomes Research at BWH and Associate Professor of Orthopedic Surgery Harvard Medical School.

"These results are extremely valuable and will enable us to work with patients and their families to identify the treatment that is best aligned with patients' preferences," said John Wright, MD, an orthopedic surgeon at BWH and lead orthopedist on the study.

Participating study sites included Cleveland Clinic, Hospital for Special Surgery, Mayo Clinic, Rush University, Vanderbilt University and Washington University. The Boston University School of Public Health Data Coordinating Center provided data management for the trial.

This research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (NIH NIAMS grants: R01 AR 055557, K24 AR 057827, P60 AR 047782).

Brigham and Women's Hospital(BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 3.5 million annual patient visits, is the largest birthing center in New England and employs more than 15,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagementand educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving nearly 1,000 physician-investigators and renowned biomedical scientists and faculty supported by $640 million in funding. For the last 19 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in organ transplantation by performing the first face transplants in the U.S. in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies, OurGenes and the Women's Health Initiative. For more information and resources, please visit BWH's online newsroom.

Lori J. Schroth | EurekAlert!
Further information:
http://www.brighamandwomens.org/

More articles from Studies and Analyses:

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Highly precise wiring in the Cerebral Cortex

Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.

The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

Im Focus: Quantum Sensors Decipher Magnetic Ordering in a New Semiconducting Material

For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.

Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...

Im Focus: Fast, convenient & standardized: New lab innovation for automated tissue engineering & drug

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Comet or asteroid? Hubble discovers that a unique object is a binary

21.09.2017 | Physics and Astronomy

Cnidarians remotely control bacteria

21.09.2017 | Life Sciences

Monitoring the heart's mitochondria to predict cardiac arrest?

21.09.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>