Role of nonoperative treatment in managing degenerative tears of the medial meniscus posterior root.

Tears of the medial meniscus posterior root can lead to progressive arthritis, and their management has no consensus. This study evaluates the effect of supervised exercise therapy on patients with medial meniscus posterior root tears.  37 patients with this tear verified by magnetic resonance imaging (MRI) and osteoarthritis grade 1-2 by radiographic examination were treated by a short course of analgesics daily for up to 6 weeks and then as required during follow-up, as well as a 12-week supervised exercise program followed by a home exercise program. Patients were followed up at 3, 6, and 12 months and annually after that using the Lysholm Knee Scoring Scale, Tegner Activity Scale (TAS), and visual analog scale (VAS). The analysis was performed using one-way analysis of variance (ANOVA) and Pearson’s correlation coefficient to determine the relationship between Lysholm score and body mass index (BMI). Results showed patients had an improvement in Lysholm score, TAS, and VAS, which reached maximum in 6 months and later was accompanied by a decline. However, scores at the final follow-up were significantly better than the pretherapy scores. There was also a progression in arthritis as per Kellgren and Lawrence radiographic classification from median 1 prior to intervention to median 2 at the final follow-up.

The authors concluded that supervised physical therapy with a short course of analgesics followed by a home-based program results in symptomatic and functional improvement over a short-term follow-up; however, osteoarthritis progression continues and is related to BMI.