How do the costs of physical therapy and knee surgery compare? Specifically for an arthroscopic partial meniscectomy.
A trial-based economic evaluation of two treatments in patients with meniscal tears alongside the ESCAPE study.
Current evidence for Physical Therapy for the treatment of non-obstructive meniscal tears in the knee is getting stronger and stronger, as opposed to operative management. Physical therapy includes physiotherapy, exercise and self-management programs.
However, some patients with knee pain due to non-obstructive meniscal tears still choose to undergo surgery as a “quick fix” for their pain and blame the costs and commitment to physical therapy as “too hard/expensive”.
What are the true costs of physical therapy, as opposed to partial menisectomy in the treatment of meniscal tears of the knee? And how do the costs of physical therapy and knee surgery compare?
This study found that over a 24 month period, physical therapy costs (average £1803) were significantly less than the costs of surgery and the costs associated with it (average £3008). Physical therapy also had higher results in other post-injury or post-op outcomes, such as quality-of-life and knee pain scores.
What is undersold about the surgery approach is that it often does not reduce knee pain immediately, and these knees are commonly under-rehabilitated post-op and further complications arise down the track (such as increased risk of onset of knee osteoarthritis) – hence the increased costs in the long term, as opposed to physical therapy.
For non-obstructive meniscal tears of the knee (tears with no locking or giving way of the knee with walking), physical therapy and exercise should be the FIRST LINE of treatment, and should be pursued for at least 7 weeks, but can be up to 2 years for full rehabilitation. This is a more cost-effective method of treatment in the long term, when opposed to arthroscopic meniscal surgery.
By Will Ryan, Physiotherapist
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How do the costs of physical therapy and arthroscopic partial meniscectomy compare? A trial-based economic evaluation of two treatments in patients with meniscal tears alongside the ESCAPE study.
To examine whether physical therapy (PT) is cost-effective compared with arthroscopic partial meniscectomy (APM) in patients with a non-obstructive meniscal tear, we performed a full trial-based economic evaluation from a societal perspective.
Article source: https://www.ncbi.nlm.nih.gov/pubmed/31227493