Effect of arthroscopic partial meniscectomy on structural degeneration of the knee - A 5-year MRI-based follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial

Sillanpää N, Iivanainen M, Turkiewicz A, Sihvonen R, Paavola M, Taimela S, Järvinen TLN, Englund M · Osteoarthritis and Cartilage

Adjusted odds ratios for progression in the meniscectomy arm, relative to the placebo-surgery arm, were 1.31 (95% CI 0.81 to 1.94) for cartilage damage, 2.86 (1.16 to 6.21) for osteophytes and 1.43 (0.84 to 2.43) for bone marrow lesions. The osteophyte estimate is the only one whose interval excludes 1, so the radiographic signal seen at 5 years rests on osteophyte formation rather than on measured cartilage loss.

Population

63 of 70 knees in the meniscectomy arm (90%) and 73 of 76 in the placebo arm (96%) with MRI at both baseline and 5 years, scored subregion by subregion with the MRI Osteoarthritis Knee Score

Intervention

Arthroscopic partial meniscectomy

Comparator

Placebo surgery

Limitations

Subregion-level analysis in a trial powered for symptoms, so the cartilage estimate is imprecise. Full text was not retrievable; the odds ratios above are the ones the structured abstract reports.