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1 The effect of exercise therapy and surgery on mechanical symptoms in young patients with a meniscal tear
  1. Camma Damsted1,2,
  2. Jonas Bloch Thorlund1,3,
  3. Per Hölmich4,
  4. Martin Lind5,
  5. Claus Varnum6,
  6. Martin Dalgaard Villumsen7,
  7. Mogens Strange Hansen8,
  8. Søren T Skou1,2
  1. 1Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark, Campusvej 55, Denmark
  2. 2The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Denmark, Region Zealand, Slagelse, Denmark, Fælledvej 2C, Denmark
  3. 3Research Unit for General Practice, Department of Public Health, University of Southern, Denmark, Odense, Denmark, Winsløws vej, Denmark
  4. 4Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Copenhagen, Denmark, Kettegård Allé , Denmark
  5. 5Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark , Palle Juul-Jensens Boulevard 99, Denmark
  6. 6Department of Orthopaedic Surgery, Lillebælt Hospital Vejle, Vejle, Denmark, Kabbeltoft 25, Denmark
  7. 7Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark, Campusvej 55, Denmark
  8. 8Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark, Falkevej 1A, Denmark

Abstract

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.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/bmjsem-2023-sportskongres2023.1

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