Knee replacement surgery can be avoided

By Michael Sheynin

A study done in a large military medical center in Texas indicates that physical therapy consisting of manual therapy and stretching and strengthening exercise regimen may help people with osteoarthritis of the knee avoid joint replacement surgery.

During the study, 83 patients with osteoarthritis of the knee were randomly assigned to two groups.The first group of 42 patients (15 men and 27 women) received treatment consisting of manual therapy and therapeutic exercise twice a week for four weeks.The second group of 41 patients (19 men and 22 women) received a placebo treatment consisting of ultrasound in a dosage far below therapeutic for the same time. Mean age was 60 and 62 years respectively.

The study states that “Distance walked in six minutes and the sum of the function, pain, and stiffness sub-scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Measures were assessed at the baseline visit and at four weeks, eight weeks, and one year post-treatment.The incidence of knee arthroplasty at one year post-treatment also was assessed.” The study reports that “Clinically and statistically significant improvements in 6- minute walk distance and WOMAC score at four weeks and eight weeks were observed in the treatment group but not in the placebo group. By eight weeks, average six-minute walk distances had improved by 13 percent and WOMAC scores had improved by 56 percent over baseline values in the treatment group.”

The study also reports that “the average distance walked in six minutes at eight weeks among patients in the treatment group was 170 more than that in the placebo group and the average WOMAC scores were 599 [points higher]. At one year, patients in the treatment group had clinically and statistically significant gains over baseline in walking distance and WOMAC scores.While 20 percent of patients in the placebo group had undergone knee arthroplasty, only 5 percent of patients in the treatment group had.”

In conclusion, the study states,“In patients with osteoarthritis of the knee, a combination of manual physical therapy and stretching, range-of-motion, and strengthening exercises may yield improvements in functional ability as well as in subjective measures of pain, stiffness, and function and may delay or prevent the need for surgical intervention.These improvements may persist well after the conclusion of clinical treatment.”

Michael Sheynin, P.T. is the co-owner of Free Motion Rehabilitation Center, 528 New Friendship Road, Howell. For more information, call 732-901-8844.