The latest evidence on treating meniscus tears without surgery
Meniscus tears are one of the most common knee injuries, particularly among athletes and active individuals. Traditionally, surgery (specifically arthroscopic meniscectomy) has been a go-to solution for symptomatic meniscus tears. However, emerging research suggests that non-surgical approaches may be just as effective, if not better, for many patients.
At Impact Physiotherapy, we stay up to date with the latest evidence to provide our clients with the best treatment options available. Here’s what you need to know about non-surgical management of meniscus tears.
Understanding the Meniscus and Its Function
The meniscus is a C-shaped piece of cartilage in the knee that acts as a cushion between the thighbone (femur) and shinbone (tibia). It plays a crucial role in absorbing shock, stabilising the knee joint, and ensuring smooth movement. A tear in the meniscus can lead to pain, swelling, stiffness, and difficulty moving the knee.
What Does the Latest Research Say?
Recent studies have shifted the narrative around meniscus tear treatment. Several high-quality randomized controlled trials (RCTs) and systematic reviews suggest that in many cases, physiotherapy and exercise-based rehabilitation provide outcomes comparable to surgery. Here are some key findings:
- Physical Therapy vs. Surgery
- The landmark 2013 study published in the New England Journal of Medicine compared arthroscopic surgery with a structured physical therapy program in patients with degenerative meniscus tears. The results showed no significant difference in pain relief and function between the two groups after six months.
- A 2020 systematic review and meta-analysis in British Journal of Sports Medicine further confirmed that supervised exercise therapy was just as effective as surgery for improving knee pain and function in middle-aged individuals with degenerative meniscus tears.
- Long-Term Knee Health
- Surgery, particularly meniscectomy (removal of part of the meniscus), has been linked to an increased risk of osteoarthritis in the long run. A 2017 study in The BMJ highlighted that patients who underwent meniscectomy were more likely to develop knee osteoarthritis compared to those who opted for non-surgical treatments.
- Success of Non-Surgical Rehabilitation
- Non-surgical treatment typically includes progressive strength training, neuromuscular exercises, manual therapy, and patient education. Programs that focus on quadriceps strengthening, balance, and knee stability have shown to be highly effective in restoring function and reducing pain.
- A study in JAMA Network Open (2022) found that approximately 80% of patients with degenerative meniscus tears avoided surgery when they followed a structured rehabilitation program.
Who Can Benefit from Non-Surgical Treatment?
Non-surgical management is particularly effective for:
- Individuals with degenerative meniscus tears (common in older adults)
- Patients without significant mechanical symptoms (such as persistent locking or severe instability)
- Those with mild-to-moderate knee arthritis alongside a meniscus tear
- Active individuals who are motivated to commit to a rehabilitation program
What Does a Non-Surgical Treatment Plan Look Like?
At Impact Physiotherapy, we tailor treatment plans based on each individual’s needs. A typical rehabilitation program for a meniscus tear may include:
- Pain Management – Initial strategies such as ice, compression, and activity modification to reduce inflammation.
- Strength Training – Targeting the quadriceps, hamstrings, and glutes to improve knee stability and function.
- Balance and Proprioception Exercises – Enhancing knee control and reducing the risk of further injury.
- Manual Therapy – Hands-on techniques to improve joint mobility and decrease stiffness.
- Education and Lifestyle Modifications – Guidance on activity modification, footwear, and weight management if necessary.
When is Surgery Still Necessary?
While non-surgical treatment is effective for many, some cases still require surgical intervention. Surgery may be recommended if:
- There is a large, complex tear causing persistent knee locking or instability.
- Symptoms do not improve after a well-structured rehabilitation program.
- The individual has an acute traumatic meniscus tear in a young, highly active athlete.
Final Thoughts
The latest evidence supports non-surgical treatment as a highly effective option for managing meniscus tears in many cases. At Impact Physiotherapy, our team of experienced physiotherapists can guide you through a tailored rehabilitation program to help you recover without the risks of surgery. If you’re dealing with knee pain or a suspected meniscus tear, get in touch with us to explore your best treatment options.
Book an appointment today and take the first step towards a stronger, healthier knee.