Study: Presence of ‘meniscal symptoms’ should not affect treatment of meniscus tears
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Investigators found “meniscal symptoms,” such as catching or locking, have no association with differential pain outcomes after surgery vs. physical therapy in patients with meniscal tears and knee osteoarthritis.
Lindsey A. MacFarlane MD, MPH, and colleagues analyzed data on 287 patients from the Meniscal Tear in Osteoarthritis Research trial to determine whether arthroscopic partial meniscectomy (APM) or physical therapy (PT) has better outcomes in the treatment of meniscal tears in patients with knee OA who report “meniscal symptoms.”
According to the study, researchers defined “meniscal symptoms” as clicking, catching, popping, intermittent locking, giving way or swelling. Primary outcome measures included differences in the KOOS pain scale for the APM and PT cohorts, as well as resolution of “meniscal symptoms.”
Overall, MacFarlane and colleagues found the presence or absence of “meniscal symptoms” had no significant effect on KOOS pain scores between the cohorts. However, the APM cohort saw a 70% resolution of intermittent locking and a 41% resolution of clicking compared with the PT cohort, 46% and 25%, respectively). Researchers noted no other differences in resolution of “meniscal symptoms” between the groups.
“Knee symptoms such as clicking and catching have historically been ascribed to meniscal pathology. This data casts further doubt on the ability of ‘meniscal symptoms’ to help direct management of meniscal tear,” MacFarlane and colleagues wrote in the study. “Although symptoms of clicking and intermittent locking had a greater reduction in the APM group, the presence of ‘meniscal symptoms’ in isolation should not inform clinical decisions surrounding APM [vs.] PT in patients with meniscal tear and knee OA.”
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