title: Arthroscopic partial meniscectomy is superior to physical rehabilitation in the management of symptomatic unstable meniscal tears.
abstract: OBJECTIVE
  Meniscus injuries are the most commonly reported in athletes. Meniscectomy is the most common treatment. Stable peripheral tears may heal, while degenerative tears do well with physical therapy. However, the exact role of physical therapy in treating symptomatic unstable meniscal tears is not known. We aimed to identify the role of physical therapy in treating such patients and clarify the role of arthroscopic partial meniscectomy in treating unstable meniscal tears.
  
  
  METHODS
  Seventy patients with unstable meniscal tear met the inclusion criteria according to Vande Berg and co-workers. Clinical examination, McMurray test and magnetic resonance imaging were done. Age ranged from 18-67 years (average 39.87). Mild osteoarthritis was seen in 20 cases. Physical therapy thrice a week for eight weeks was offered (faradic quadriceps stimulation and neuromuscular strengthening exercises). After physical therapy, patients still complaining or unsatisfied were offered arthroscopic partial menisectomy (APM). Outcomes were evaluated using the VAS pain score and the Lysholm knee score.
  
  
  RESULTS
  Mean VAS before interventions was 7.4, significantly improved to 5.16 after rehabilitation and to 1.9 after APM (p = 0.001). Mean Lysholm score before rehabilitation was 65.1 and improved to 69.6 after rehabilitation, the difference was non-significant. However, Lysholm score difference before and after APM showed a highly significant difference (p = 0.001).
  
  
  CONCLUSIONS
  Pain and swelling improved after physical therapy. However, patients were not satisfied as limited range of knee motion persisted. APM was superior to physical therapy in treating symptomatic unstable meniscal tears, with high patient satisfaction and restored knee function.
authors.affiliation: Orthopedic Surgery Department, Ain Shams University Hospital, Ain Shams University, Cairo, Egypt, sherifghazaly@hotmail.com.
authors.forename: Sherif A
authors.initials: SA
authors.lastname: El Ghazaly
authors.forename: Amr A Abdul
authors.initials: AA
authors.lastname: Rahman
authors.forename: Ahmed H
authors.initials: AH
authors.lastname: Yusry
authors.forename: Mahmoud M
authors.initials: MM
authors.lastname: Fathalla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D026741:Physical Therapy Modalities; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome; D055815:Young Adult