NEW RESEARCH SHOWS ARTHROSCOPIC KNEE SURGERY NO
BETTER THAN PHYSICAL THERAPY, MEDICAL MANAGEMENT
New England Journal of Medicine Study Questions
Value of Knee Surgery
ALEXANDRIA, VA, Sept 11, 2008 — A new study questioning the
usefulness of arthroscopic surgery for osteoarthritis of the knee should
encourage patients to consider physical therapy as an effective
non-surgical option, according to the American Physical Therapy
Association (APTA). The study was published in the September 11 issue of
the New England Journal of Medicine (NEJM).
The study found that knee surgery is no better than
physical therapy, combined with comprehensive medical management, at
relieving the pain and stiffness of moderate to severe osteoarthritis of
the knee.
"This study offers hope and encouragement to persons with
osteoarthritis who would like to avoid the pain and emotional toll of
surgery," said APTA President R Scott Ward, PT, PhD. "Too often, the
first line of defense is surgery when it need not always be. Physical
therapy can be equally effective and should be considered by not only
patients themselves, but also the primary care doctors and orthopedists
who are treating them."
According to physical therapist Christopher M Powers, PhD, PT,
director of the Biokinesiology program and co-director of the
Musculoskeletal Biomechanics Research Lab at the University of Southern
California Division of Biokinesiology & Physical Therapy, "Many
times knee pain is associated with abnormal movement patterns that cause
increased stress on the joint. Arthroscopic surgery does little to
correct the dynamic factors that may be contributing to knee pain and
pathology. These findings reinforce the need for a comprehensive
treatment approach for such patients."
The NEJM study adds to a growing body of evidence supporting physical
therapy for treatment of osteoarthritis of the knee, including:
- A report published in the January 2008 issue of the journal Physical
Therapy that reviewed research on osteoarthritis of the knee from
2000 to 2007 and found "high-quality evidence that exercise and weight
reduction reduce pain and improve physical function."
- A study published in the Feb 1, 2000 issue of the Annals of Internal
Medicine that concluded "a combination of manual physical therapy
and supervised exercise yields functional benefits for patients with
osteoarthritis of the knee and may delay or prevent the need for
surgical intervention."
A physical therapist will perform a thorough examination and design a
plan of care that may include:
- A series of exercises designed to help improve motion. Activities in
this phase might include water walking, swimming, and flexibility
exercises.
- An exercise sequence to restore strength including a functional
progression, that is, a gradual return to normal activities using
exercises that simulate the knee stresses of your normal
activities.
A knee's tolerance for stressful activities often decreases with age
and loss of conditioning. As a result, stresses that would not have
caused pain or injury to the knee last year could today. A decrease in
levels of activity over a period of time may also contribute to the
vulnerability of knees.
But there are steps one can take to help prevent injury in order to
continue enjoying sports and exercise. Pursuing an exercise program
designed by a physical therapist can be one of the best protections from
injury.
The first step in designing your exercise program is an evaluation by
your physical therapist. He or she can identify your predisposing
factors, those body traits that may make you more or less vulnerable to
a knee injury. Based on this evaluation, your physical therapist can
design a program that will help you gain your optimum levels of
function, strength and conditioning.
Physical therapy plays a key role in treating and rehabilitating the
knee, but the patient's attitude toward recovery plays a big factor in
achieving a successful outcome. For more information on taking care of
your knees and to find a physical therapist, visit www.apta.org/consumer.
APTA (www.apta.org) is a national organization representing physical
therapists, physical therapist assistants, and students nationwide. Its
goal is to foster advancements in physical therapist education,
practice, and research. Consumers can visit www.findapt.us to find
a physical therapist in their area, as well as www.apta.org/consumer for physical therapy news and
information.
[Last updated: 05/04/09 | Contact: public-relations@apta.org]
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