The Meniscus Surgery Debate
Multiple high-quality randomised controlled trials — including the landmark FINN study — have shown that physiotherapy produces outcomes equivalent to arthroscopic partial meniscectomy for degenerative meniscal tears in middle-aged patients.
Conservative Physiotherapy Approach
Phase 1 (Weeks 0–4): Swelling control, range of motion restoration, VMO activation, straight-leg raises. Phase 2 (Weeks 4–12): Progressive strength training focusing on quadriceps and hamstrings. Phase 3 (Months 3–6): Return to activity with dynamic stability training.
When Surgery Genuinely Helps
Traumatic bucket-handle tears in young athletes with true locking of the knee have good surgical outcomes. Peripheral tears in the vascular zone of the meniscus can be repaired surgically with good healing potential.
Protecting the Meniscus Long-Term
Quadriceps strength is the strongest predictor of meniscal health. Strong quads reduce the load transmitted to the meniscus by 25%. Weight management multiplies this protective effect.