The consumer information site Choose Wisely last year posted a warning about the questionable effectiveness for knee arthroscopy surgery in people with knee arthritis or degenerative meniscus (cartilage) tears.
A growing number of research trials have been showing that there is no benefit to a knee arthroscope over non operative treatment (like physiotherapy) in certain situations. As a physiotherapy practice who treats thousands of sufferers of knee arthritis each year, we have known this for a long time. Without question, the most powerful influence on how much pain you experience from your arthritic knee – irrespective of how much arthritis is present on your scans – is the strength of your surrounding muscles. Over & over we see people with quite severe arthritis on their x-ray who experience minimal pain (due to their supreme muscle strength) & conversely those will only mild arthritis on their x-ray who experience severe pain (due to their extremely weak muscles).
Which muscles should I strengthen?
Research suggests that weight bearing exercise, specifically targeting each of the muscles in your lower body, is the best approach. We have been involved in some research in conjunction with the University of Melbourne, where we specifically targeted the following muscles:
- Gluteal (buttock) muscles
- Quadriceps (in the front of your thigh)
- Calf (back of your lower leg)
The stronger these muscles are, the better support & shock absorption they are able to provide your arthritic knee. The vast majority of the clients we designed strengthening programs for through this research trial experienced a significant reduction in their arthritic knee pain as a result of improving their muscle strength.
How long does it take?
Whilst many participants in the trial started to see some reduction in pain after just a few weeks, most of them required at least 6 weeks of strengthening work (done 3 times per week) to experience a significant pain reduction.
Is there ever a situation that requires a knee arthroscope?
Yes – knee arthroscope still has its place. In an acute meniscal tear due to a one off twisting incident – where the torn flap continues to get caught in the joint severely limiting the movement of your knee joint – then you typically do need an arthroscope performed to cut the torn piece out. If you are in doubt as to whether this applies to you, then you can book a FREE assessment with one of our expert physiotherapists to get some specific advice for your situation.
Adrian Quinn (Member APA)
Physiotherapist & Practice Director, Back In Motion Camberwell