PURPOSE: To present the effects of using manual therapy in patients who had knee pain related to degenerative meniscus tear.

RELEVANCE: Eight weeks of (twice per week) physical therapy were reported in 2 studies to have resulted in 16% to 25% improved Lysholm knee scores in patients with degenerative meniscus tear. However, only therapeutic exercises (not manual therapy) were incorporated in the conservative management, as disseminated by the published reports.

CASE DESCRIPTION: A series of 5 patients with a mean  SD age of 58 - 7.8 years (90% CI) had an initial Lower Extremity Functional Scale (LEFS) average SD of 35.8 11.4 (90% CI) out of 80. The patients presented with knee pain and MRI evidence of degenerative meniscus tear. Decreased knee varus mobility was noted in all patients. Therefore, knee varus mobilization was utilized as a specific manual therapy technique in these patients.

RESULTS: Patients were seen for 3.0  0.9 (90% CI) visits, resulting in a final LEFS average of 59.4  10.6 (90% CI). Other impairments were addressed after the final LEFS was collected to isolate the effect of manual therapy. The change from initial to final LEFS score was 66%, and this was achieved within 1 month. Finally, the follow-up (6-month minimum) LEFS score collected had an average of 57.6  6.53 (90% CI). In summary, manual therapy compared favorably with conventional exercises (based on percent improvement in function, cumulative total number of visits, and treatment duration).

CONCLUSIONS: Manual therapy as applied to patients who presented with (MRI evidence of) degenerative meniscus tear resulted in positive outcome. However, care must be taken not to extrapolate these results in similar patients until more study is done to determine cause and effect.

IMPLICATION: Manual therapy offers a promising and viable alternative to traditional exercises for nonoperative intervention of degenerative meniscus tear.