Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis.

Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. 
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. 
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