title: Role of nonoperative treatment in managing degenerative tears of the medial meniscus posterior root.
abstract: BACKGROUND
  Tears of the medial meniscus posterior root can lead to progressive arthritis, and its management has no consensus. The aim of our study was to evaluate the effect of supervised exercise therapy on patients with medial meniscus posterior root tears.
  
  
  METHODS
  Between January 2005 and May 2007, 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. Final analysis was performed for 33 patients, average age 55.8 (range 50-62) years and average follow-up of 35 (range 26-49) months. Patients were followed up at 3, 6, and 12 months and yearly thereafter 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
  Patients showed 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 preintervention to median 2 at the final follow-up. A correlation between BMI and Lysholm scores was seen (r = 0.47).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Devdatta Suhas
authors.initials: DS
authors.lastname: Neogi
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.forename: Laxman
authors.initials: L
authors.lastname: Rijal
authors.forename: Chandra Shekhar
authors.initials: CS
authors.lastname: Yadav
authors.forename: Ashish
authors.initials: A
authors.lastname: Jaiman
authors.forename: Hira Lal
authors.initials: HL
authors.lastname: Nag
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D018771:Arthralgia / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D053587:Arthrometry, Articular / Q000379:methods; D001696:Biomechanical Phenomena; D015992:Body Mass Index; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome
chemical_list: D000700:Analgesics