Physical therapy noninferior to arthroscopic surgery for meniscal tear
Exercise-based physical therapy is noninferior to arthroscopic partial meniscectomy for patient-reported knee function at five years among patients with a degenerative meniscal tear, according to a study published online July 8 in JAMA Network Open.
Julia C.A. Noorduyn, from OLVG Amsterdam, and colleagues compared the five-year effectiveness of arthroscopic partial meniscectomy and exercise-based physical therapy in 321 patients aged 45 to 70 years with a degenerative meniscal tear. Participants were randomly assigned to arthroscopic partial meniscectomy or 16 sessions of exercise-based physical therapy; 87.1 percent competed the five-year follow-up (mean follow-up, 61.8 months).
The researchers found that mean improvement was 29.6 and 25.1 points on the International Knee Documentation Committee Subjective Knee Form in the surgery and physical therapy groups, respectively, from baseline to follow-up. There was a 3.5-point crude between-group difference (95 percent confidence interval, 0.7 to 6.3 points; P < 0.001 for noninferiority); the 95 percent confidence interval did not exceed the 11-point noninferiority threshold. Rates of progression of radiographic-demonstrated knee osteoarthritis were comparable between both treatment groups.
"Findings from this trial further support the recommendation that exercise-based physical therapy should be the preferred treatment over surgery for degenerative meniscal tear," the authors write.
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