We all get old and guess what? with a little luck we all get there. One of the joys of middle age and beyond is arthritis. The knee is one of those joints prone to injury, especially with advancing age.

One common injury is a meniscal tear, which involves damage to the cartilage which helps cushion the knee joint.

In the past many such meniscal tears end up in surgery. In fact worldwide about 2 million people undergo knee arthroscopy every year. And the evidence that it benefits patients is not that great.

A recent study compared exercise therapy alone with arthroscopic surgery in middle aged patients with arthritis and tears in the meniscus from chronic use.

Half of the 140 studied patients received a supervised exercise program over 12 weeks and half arthroscopic surgery followed by simple exercises at home.

No difference was found in terms of ability to do sports, amount of pain and knee related quality of life. No serious events were seen in either group.

What this means is that if you are middle aged and are found to have a chronic tear of your meniscus, think twice about whether you want surgery.