Introduction A common treatment strategy to alleviate mechanical symptoms in young patients with meniscal tears is meniscal surgery, however, it is unknown whether this is superior to a non-surgical strategy. Therefore, we aimed to compare meniscal surgery to early exercise therapy and patient education.
Materials and Methods In a randomized controlled trial, 121 patients aged 18–40 years with a MRI-verified meniscal tear were randomized to surgery or 12-weeks supervised exercise and education. For this study 63 patients (33 and 30 patients in surgery and exercise groups, respectively) reporting baseline mechanical symptoms were included. Primary outcome was self-reported mechanical symptoms (yes/no) at 3, 6, and 12 months assessed using a single item from the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes were KOOS4 and the 5 KOOS-subscales and the Western Ontario Meniscal Evaluation Tool (WOMET).
Results In total, 55/63 patients completed the 12-month follow-up. At 12 months 9/26 (35%) in the surgery group and 20/29 (69%) in the exercise group reported mechanical symptoms. The risk difference and relative risk at any time point was 28.7% (95% CI 8.6 to 48.8) and 1.83 (95% CI, 0.98 to 2.70) of reporting mechanical symptoms in the exercise group compared with the surgery group. No between group differences were found in secondary outcomes.
Conclusion Surgery seems to be more effective for relieving self-reported mechanical symptoms, but not for improving pain, function and quality of life in young patients with a meniscal tear and mechanical symptoms compared with a strategy of exercise and education.
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