Katz, J. et al. The New England Journal of Medicine, 2013.
http://www.nejm.org/doi/full/10.1056/NEJMoa1301408
While much attention has been recently
brought to whether surgery is better than rehabilitation alone in case of ACL
injury, there appears lack of research investigating the same in patients with
meniscal tear and knee OA. Authors conducted this multicenter, randomized,
controlled trial to check whether arthroscopic partial meniscectomy for
symptomatic patients with a meniscal tear and knee osteoarthritis is better than
physical therapy with an option of delayed surgery. 351 patients participated
in the study. The primary outcome measure, evaluated at 6 and 12 months, was Western
Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
Study found no significant differences
between groups in the WOMAC score at 6 and 12 months. The mean improvement in
the WOMAC score at 6 months was 20.9 in the surgical group and 18.5 in the
rehabilitation group. Similar results have been found at 12 months. In
addition, 51 (30%) participants from the physical therapy group, decided to
undergo surgery.
This study found that arthroscopic partial meniscectomy for symptomatic patients with a meniscal tear and knee osteoarthritis is no better than rehabilitation alone. Nevertheless, authors confirm some limitations of the study and point out that 30% participants from the physical therapy group, crossed over to surgical group, therefore study finding should be interpreted with caution.
This study found that arthroscopic partial meniscectomy for symptomatic patients with a meniscal tear and knee osteoarthritis is no better than rehabilitation alone. Nevertheless, authors confirm some limitations of the study and point out that 30% participants from the physical therapy group, crossed over to surgical group, therefore study finding should be interpreted with caution.
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