HealthDay News – Outcomes in patients with magnetic resonance imaging-verified degenerative medial meniscal tears, but no current radiographic evidence of osteoarthritis, were similar in those undergoing arthroscopic partial meniscetomy and those receiving supervised exercise therapy. The results from this randomized, parallel intervention groups were recently published in The BMJ.

Nina Jullum Kise, MD, an orthopedic surgeon at Martina Hansens Hospital in Sandvika, Norway, and colleagues tracked outcomes for 140 patients who were randomized to undergo either arthroscopic partial meniscetomy versus exercise treatment (Clinicaltrials.gov Identifier (NCT01002794). 

These patients averaged 50 years of age and had degenerative meniscal tears, largely without any signs of osteoarthritis. Half of the patients performed two to three supervised exercise sessions a week for three months, while the other half underwent arthroscopic surgery, followed by simple daily exercises at home.


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After three months, thigh strength improved in the exercise group, but not in the surgery group, the researchers found. After two years, pain, sports and recreation function, and knee-related quality of life were similar for both groups. Thirteen (19%) of the patients in the exercise group also underwent knee surgery during the study follow-up period, but it did not provide them with any additional benefits.

“Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option,” the authors write.

Summary and Clinical Applicability

“Supervised exercise therapy should be considered as a treatment option for patients with pain and degenerative meniscal tears verified by magnetic resonance imaging, and without radiographic signs of osteoarthritis,” they concluded. 

Reference

Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up. BMJ. 2016;354:i3740.

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