There is an interesting discussion right now as to the benefits of arthroscopic knee surgery. For this topic of discussion is meniscal surgery worth it? Or can a person be just fine without it? As a physical therapist, I routinely field this question from those debating surgery. Unfortunately, the answer is not always clear cut. Plus are they willing to wait and see how therapy progresses?

The specific reasons for the surgery are often varied, however the most often cited reasons are to clean up some arthritis or meniscal debris. An important question is, are the imaging findings on which the knee surgery is based off of relevant? Buchbinder reports degenerative tears are common and poorly relate to imaging findings. The means plenty of people walk around with them with no issue. So will surgery “FIX” the problem?

Obviously individual results do vary, however, an article published by Thorlund and colleagues in the British Medical Journal found little benefit in terms of pain and/or physical function in those opting for surgery. This report should make one question why they would undergo surgery to not be better on the back end of things.

Many individuals think these clean up procedures are simple and easy because the surgeon says so. For some that may be true, but not all. I unfortunately have personal experience in this arena with a family member. The individual was no better following surgery. Worse they have been unable to be as physically active following what should have been a simple/routine procedure.

In addition to not having reduced pain or improved function, with surgery comes risk. Common risks associated with all surgeries includes: DVTs, pulmonary embolism, and infections. None of these are things one desires to experience. At the same time, large quantities of NSAIDs such as ibuprofen or Tylenol should be taken with caution as complications from these medications can occur such as ulcers, and liver and/or kidney dysfunction depending on the medication taken.

I write this to tell you that all conservative options should be exhausted prior to surgical intervention. Individuals who truly put forth a good effort with physical therapy/rehab have at least an equal chance of improvement as opting for surgery. I am not telling you therapy will be easy, quite the contrary. A good deal of effort to address strength, flexibility and balance will all be necessary to achieve meaningful improvement. Now many may not be willing to put in the work, however, do you think you will not have to put in rehab following surgery? If that is your belief, you will fail miserably. Pro athletes put in weeks of rehab to return following these procedures. Do you have round the clock access to professionals to help you get there?

If you are someone considering knee surgery, I urge you to seek physical therapy first. It may save you months or years of pain and frustration and comes without all the risks of medication and surgery.