Arthroscopic partial meniscectomy versus physical therapy for traumatic meniscal tears in a young study population: a randomised controlled trial

van der Graaff SJA, Eijgenraam SM, Meuffels DE, van Es EM, Verhaar JAN, Hofstee DJ, Auw Yang KG, Noorduyn JCA, Bierma-Zeinstra SMA, Bindels PJE, Reijman M · British Journal of Sports Medicine

At 24 months IKDC was 78 (95% CI 71 to 84) in the meniscectomy group and 78 (95% CI 71 to 84) in the physical-therapy group, a between-group difference of 0.1 points (95% CI -7.6 to 7.7). Twenty-one of the 51 physical-therapy patients (41%) took the delayed operation. Both groups improved by a clinically relevant margin from baseline.

Population

100 patients aged 18 to 45, mean age 35.1 (SD 8.1), 76% male and 34 competitive or elite athletes, with a recent-onset traumatic MRI-verified isolated meniscal tear and no knee osteoarthritis

Intervention

Early arthroscopic partial meniscectomy

Comparator

Standardised physical therapy with optional delayed meniscectomy after 3 months

Limitations

Open-label, 100 patients, and the physical-therapy arm was a strategy including delayed surgery rather than physical therapy alone — 41% took it. It tests the timing of the operation in a young traumatic tear, not whether the operation is ever needed.