Think yet again before knee surgery...the broken record for today's times

Lots of press will be forthcoming on 2 new studies (here and here) questioning the benefits of arthroscopic knee surgery in favor of physical therapy for patients with knee OA. Nothing surprising here, especially with high quality studies like this and this supporting the value of manual physical therapy and therapeutic exercise (among many others). Incidentally, the 2 new NEJM studies remind me of this study that was published back in 2002 (abstract here).

Any common theme here? How about "Go to a PT First". The same model that has been proven time and time again for back pain will work for knee OA as well. It sounds like a broken record, but you can have surgery, you can have drugs, or you can see a physical therapist. It wouldn't be all that difficult if health care had something to do with the patient's best interest. Sounds like the AOSSM needs to get together and for the knee surgeon's version of the Association for Ethics in Spine Surgery. Not trying to paint with a broad brush here (there are good orthopaedists out there who appreciate the value of high quality non surgical management), just that if history prevails, it will be about 15 years before we see practice catching up with evidence.

The best days for PT remain ahead. How long will it be until someone other than our profession recognizes this?

Your thoughts?

John