Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up
- PMID: 22437659
- DOI: 10.1007/s00167-012-1960-3
Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up
Abstract
Purpose: The aim of this prospective randomized intervention study was to evaluate the outcome at a 2 and 5 year follow-up whether combined arthroscopic surgery followed by exercise therapy was superior to the same exercise therapy alone when treating non-traumatic, degenerative medial meniscal tears.
Methods: Ninety-six middle-aged patients with MRI-verified degenerative medial meniscus tear and radiographic osteoarthritis grade ≤1 (Ahlbäck) participated in the study. Radiographic examination was done before randomization and after 5 years. The patients were randomly assigned to either arthroscopic treatment followed by exercise therapy for 2 months or to the same exercise therapy alone. At the start of the study and at the follow-ups at 24 and 60 months the patients answered three questionnaires KOOS, Lysholm Knee Scoring Scale and Tegner Activity Scale and made pain ratings on the Visual Analogue Scale (VAS).
Results: Both groups showed highly significant clinical improvements from baseline to the follow-ups at 24 and 60 months on all subscales of KOOS, Lysholm Knee Scoring Scale and VAS (p < 0.0001). No group differences were found at any of the testing occasions. One third of the patients that were treated with exercise therapy alone did not feel better after the treatment but were improved after arthroscopic surgery. According to radiographic findings two patients from each group had a slight progression of their osteoarthritis after 5 years.
Conclusion: The findings indicate that arthroscopic surgery followed by exercise therapy was not superior to the same exercise therapy alone for this type of patients. Consequently, exercise therapy can be recommended as initial treatment. However, one third of the patients from the exercise group still had disabling knee symptoms after exercise therapy but improved to the same level as the rest of the patients after arthroscopic surgery with partial meniscectomy.
Level of evidence: I.
Similar articles
-
Improved Outcome With Knee Arthroscopy Relative to Physiotherapy for Symptomatic Unstable Meniscal Tears: 2-Year Prospective Cohort Study.Sports Health. 2024 May-Jun;16(3):370-376. doi: 10.1177/19417381231156378. Epub 2023 Mar 10. Sports Health. 2024. PMID: 36896669 Free PMC article.
-
Arthroscopic partial meniscectomy combined with medical exercise therapy versus isolated medical exercise therapy for degenerative meniscal tear: A meta-analysis of randomized controlled trials.Int J Surg. 2020 Jul;79:222-232. doi: 10.1016/j.ijsu.2020.05.035. Epub 2020 Jun 6. Int J Surg. 2020. PMID: 32522685 Review.
-
Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus.Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):335-346. doi: 10.1007/s00167-016-4407-4. Epub 2017 Feb 16. Knee Surg Sports Traumatol Arthrosc. 2017. PMID: 28210788 Free PMC article.
-
Arthroscopic partial meniscectomy in middle-aged patients with mild or no knee osteoarthritis: a protocol for a double-blind, randomized sham-controlled multi-centre trial.BMC Musculoskelet Disord. 2013 Feb 25;14:71. doi: 10.1186/1471-2474-14-71. BMC Musculoskelet Disord. 2013. PMID: 23442554 Free PMC article. Clinical Trial.
-
Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial.Knee Surg Sports Traumatol Arthrosc. 2007 Apr;15(4):393-401. doi: 10.1007/s00167-006-0243-2. Epub 2007 Jan 10. Knee Surg Sports Traumatol Arthrosc. 2007. PMID: 17216272 Clinical Trial.
Cited by
-
Examining the Evidence Regarding Smoking and Patient Outcomes for Isolated Meniscus Pathology: A Comprehensive Systematic Review and Meta-Analysis.Life (Basel). 2024 Apr 30;14(5):584. doi: 10.3390/life14050584. Life (Basel). 2024. PMID: 38792605 Free PMC article. Review.
-
Top 15 musculoskeletal lesions in the aging recreational sporter: a pictorial review.Quant Imaging Med Surg. 2023 Nov 1;13(11):7552-7571. doi: 10.21037/qims-22-1294. Epub 2023 Apr 14. Quant Imaging Med Surg. 2023. PMID: 37969624 Free PMC article. Review.
-
Introduction of an easy-to-operate arthroscopic test in detecting and treatment of meniscal instability: "suction drift" test.Am J Transl Res. 2023 Sep 15;15(9):5594-5601. eCollection 2023. Am J Transl Res. 2023. PMID: 37854208 Free PMC article.
-
Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR).Int J Sports Phys Ther. 2023 Oct 1;18(5):1094-1105. doi: 10.26603/001c.86129. eCollection 2023. Int J Sports Phys Ther. 2023. PMID: 37795315 Free PMC article.
-
Radiographic Changes Five Years After Treatment of Meniscal Tear and Osteoarthritic Changes.Arthritis Care Res (Hoboken). 2023 Jul 20:10.1002/acr.25197. doi: 10.1002/acr.25197. Online ahead of print. Arthritis Care Res (Hoboken). 2023. PMID: 37474452
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Research Materials