Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial

Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Järvinen TLN · Annals of the Rheumatic Diseases

At 24 months WOMET improved 27.3 points after meniscectomy versus 31.6 after placebo surgery (between-group difference -4.3; 95% CI -11.3 to 2.6), Lysholm 23.1 versus 26.3 (-3.2; -8.9 to 2.4), and knee pain after exercise 3.5 versus 3.9 (-0.4; -1.3 to 0.5). The two pre-specified subgroups that clinical reasoning predicts should benefit — patients reporting mechanical symptoms, and patients with an unstable tear — separated no better than the whole trial.

Population

The same 146 FIDELITY participants, followed to 24 months

Intervention

Arthroscopic partial meniscectomy

Comparator

Placebo surgery

Limitations

Single trial, one country, and the degenerative indication only. The subgroup analyses were pre-specified but the trial was not powered for them, so they narrow the room for a responder subgroup rather than closing it.