Surgery or Physical Therapy for Knee Pain?

When faced with knee injury, what is a patient’s better option: surgery or physical therapy? If you have been reading our blog posts you know that we advocate Prolotherapy as an alternative to knee surgery and physical therapy because in our opinion,  Prolotherapy does a superior job of treating and curing the root cause of knee injury. We recently, however, came across a study from the Washington University School of Medicine that we found quite interesting.

Surgery or Physical Therapy?

Researchers studied 351 patients with either a torn meniscus or knee osteoarthritis for 12 months. They randomly assigned the patients to either a physical therapy group or an arthroscopic surgery group. They evaluated each patient’s pain and knee function at six and 12 months and discovered that after one year the results were about the same: both had some improvement with no significant difference between the two treatment options. The one interesting fact is that patients had the option to crossover into the other treatment group. 51 patients in the physical therapy group decided to go ahead with surgery, whereas only 9 patients in the surgery group chose to switch to physical therapy. No reasons were given as to why the patients decided to switch.1

Alternative to knee surgery

You don’t have to search long on this website to see find research citing the dangers of surgery for a torn meniscus. The meniscus is an essential part of the knee and surgery usually entails removing part of this essential structure. A compete or partial menisectomy leads to further degeneration in the knee and puts the patient at risk for long-term knee osteoarthritis. For the knee osteoarthritis patient, “shaving” or “scoping” loose cartilage is detrimental to the knee. Knee surgery often does more harm than good and has repercussions adverse long-term effects.  A more conservative and effective option is to receive Prolotherapy for the torn meniscus and knee osteoarthritis so that the tissue can be rebuilt and full knee function can be restored.

Alternative to physical therapy

Physical therapy is great in many circumstances, but in the case of a soft tissue injury that is not healing on its own, i.e. a torn meniscus or knee osteoarthritis, a more aggressive treatment is needed. Prolotherapy is able to stimulate the body’s immune system to initiate the natural healing cascade to repair the soft tissue injury.

surgery and physical therapy produce the same results in knee pain and function

Bottom line, according to this study, surgery and physical therapy produce the same results in knee pain and function. Physical therapy is obviously the more conservative option in that it is less costly, less time intensive, and less invasive. But does it completely heal? Knee pain patients want a permanent cure, and that cure is best found in Prolotherapy.

1. Katz JN, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. The New England Journal of Medicine, published online March 19, 2013, at
DOI: 10.1056/NEJMoa131408