Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear

Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Järvinen TL · The New England Journal of Medicine

At 12 months the intention-to-treat analysis found no significant between-group difference in any primary outcome. Lysholm improved 21.7 points in the meniscectomy group and 23.3 in the sham group (between-group difference -1.6; 95% CI -7.2 to 4.0); WOMET 24.6 and 27.1 (-2.5; 95% CI -9.2 to 4.1); knee pain after exercise 3.1 and 3.3 (-0.1; 95% CI -0.9 to 0.7). Two patients in the meniscectomy group and five in the sham group needed later knee surgery.

Population

146 adults aged 35 to 65 with knee symptoms consistent with a degenerative medial meniscus tear and no knee osteoarthritis, in five Finnish public hospitals

Intervention

Arthroscopic partial meniscectomy

Comparator

Sham surgery — a simulated procedure matching the sounds, sensations and operating-room time of the real one

Limitations

Patients with a clearly traumatic onset or a recently locked knee were excluded, so the result speaks to the degenerative indication only. Full text was not retrievable; the outcome above is written from the between-group statistics the abstract states outright, and the later FIDELITY follow-ups in this shard were read in full.