Physical therapy preferred vs. arthroscopic partial meniscectomy for meniscal tears
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Exercise-based physical therapy remained noninferior to arthroscopic partial meniscectomy regarding self-reported knee function and should be the preferred treatment for patients with degenerative meniscal tears, according to results.
Julia C. A. Noorduyn, MSc, and colleagues randomized 162 patients to 16 sessions of exercise-based physical therapy and 159 patients to undergo arthroscopic partial meniscectomy for degenerative meniscal tears between July 12, 2013, and Nov. 5, 2015. All patients were aged 45 to 70 years. Outcome measures were collected 3, 6, 12, 24 and 60 months after randomization and included, among other outcome measures, patient-reported knee function and progression of knee osteoarthritis on radiograph.
From baseline to 5-year follow-up, the surgery group had a mean improvement of 29.6 in IKDC scores, while the physical therapy group had a mean improvement of 25.1. Researchers also found small and comparable rates of knee OA progression the surgery group and the physical therapy group.
With comparable knee function scores and rates of OA progression at 5 years, Noorduyn and colleagues determined exercise-based physical therapy to be noninferior to arthroscopic partial meniscectomy.
“Findings from this trial further support the recommendation that exercise-based physical therapy should be the preferred treatment over surgery for degenerative meniscal tears,” Noorduyn and colleagues wrote in the study.
“Future research using a longer follow-up period and more accurate research methods (such as MRI assessments) is needed to assess if surgery is associated with a higher risk of developing knee OA compared with physical therapy,” Noorduyn told Healio.
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