Arthroscopic meniscectomy holds out the promise of a quick and minimally invasive fix for injured knees, but a new multi-center study questions whether its outcomes are any better than basic physical therapy.

For the study, published online in the New England Journal of Medicine, researchers from 7 universities and orthopedic surgical centers observed the cases of 351 patients aged 45 and older who suffered from meniscus tears and osteoarthritic knees.

Some of the patients underwent surgery to repair the injuries, followed by post-operative physical therapy. Others undertook a regimen of physical therapy and exercise. When researchers evaluated the patients 6 months after treatment began, they didn't find a significant difference in the 2 groups' average functional improvement or pain scores.

"Both are very good choices," said lead author Jeffrey N. Katz, MD, of Brigham and Women's Hospital in Boston and the Harvard Medical School. But "it would be quite reasonable to try physical therapy first because the chances are quite good that you'll do quite well."

An accompanying editorial pointed out that patients who first seek the non-operative therapy route may spare themselves the risks and costs of surgery.

David Bernard