Brief summary, from the abstract
In this randomized trial of older adults with nonobstructive meniscal tears, physical therapy was noninferior to early arthroscopic partial meniscectomy for improving patient-reported knee function over 24 months, suggesting therapy can be a reasonable first option instead of surgery.
- 321 patients aged 45 to 70 were randomized to arthroscopic partial meniscectomy (APM) or physical therapy (PT) and followed for 24 months.
- Knee function (IKDC) improved by 26.2 points with surgery (44.8 to 71.5) versus 20.4 points with PT (46.5 to 67.7); the between-group difference of 3.6 points (97.5% CI, negative infinity to 6.5; P for noninferiority = .001) stayed within the prespecified 8-point noninferiority margin.
- Treatment crossover was notable: 47 PT participants (29%) went on to have surgery during follow-up, so results reflect a strategy that allows later surgery if needed.
- Single multicenter randomized trial in older patients with nonobstructive tears; findings may not extend to younger patients or other tear types.
Clinically assessing this area? See the knee special tests.