More Evidence That Meniscal Tears Might Not Require Surgery.

[Argirios Argiriou]

January 28, 2014
More Evidence That Meniscal Tears Might Not Require Surgery.

Jonathan S. Coblyn, MD reviewing Sihvonen R et al. N Engl J Med 2013 Dec 26.

Sham arthroscopy was as effective as arthroscopic repair for meniscal tears without osteoarthritis.

In a recent study, patients with coexisting meniscal tears and osteoarthritis who were treated with physical therapy alone or with arthroscopic repair followed by physical therapy had similar outcomes (NEJM JW Gen Med Mar 28 2013). Now, investigators in Finland have conducted a randomized trial in which nearly 150 patients (age range, 35–65) with knee pain consistent with nontraumatic meniscal tears and no osteoarthritis were assigned to either arthroscopic partial meniscectomy or sham arthroscopy. Patients were followed for 1 year. All patients underwent the same postoperative care, including a graduated exercise program.

During follow-up, both groups showed marked improvements in knee pain–related scores — after exercise and 12 months after surgery — and no significant between-group differences were observed. Of the seven patients who underwent additional surgeries because of persistent symptoms, two were in the meniscectomy group and five were in the sham group, but this difference was not statistically significant.

Comment

This study adds to growing evidence that patients with nontraumatic meniscal tears (with or without osteoarthritis) probably do not require arthroscopic surgery, at least not initially. Time and physical therapy might yield similar outcomes with much less expense.


Citation(s):

    Sihvonen R et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 2013 Dec 26; 369:2515. (Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος)

- See more at: Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

[Argirios Argiriou]

More Evidence That Meniscal Tears Might Not Require Surgery.

Jonathan S. Coblyn, MD reviewing Sihvonen R et al. Ann Rheum Dis 2018 Feb .

This 2-year follow-up study still shows no benefit of partial meniscectomy compared with a sham procedure.

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

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