Abstract
OBJECTIVE: To compare the effect of early meniscal surgery versus exercise and education with the option of later surgery on pain, function, and quality of life in young patients with a meniscal tear, taking symptom onset into account.
DESIGN AND METHODS: In a randomized controlled trial (the DREAM-trial), 121 patients aged 18-40 years with MRI-verified meniscal tear were randomized to surgery or 12-weeks supervised exercise and patient education. For this exploratory study, the analyses were stratified by symptom onset (traumatic/non-traumatic). The main outcome was the difference in change after 12 months in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS4) subscales covering pain, symptoms, function in sport and recreation and quality of life.
RESULTS: Forty-two patients (69%) in the exercise therapy group and 47 (78%) in the surgery group were categorized as having a traumatic tear. We observed no difference in change in KOOS4 after 12 months between the two treatment groups for either traumatic tears (18.8 vs. 16.0 in the surgery vs. exercise therapy groups; adjusted mean difference, 4.8 [95% confidence interval, -1.7 to 11.2]) or non-traumatic tears (20.6 vs. 17.3 in the surgery vs. exercise therapy groups; adjusted mean difference, 7.0 [95% confidence interval, -3.7 to 17.7]).
CONCLUSION: In patients with traumatic and non-traumatic meniscus tears, early meniscal surgery did not appear superior to exercise and education in improving pain, function, and quality of life after 12-months. Further research is needed to confirm the clinical applicability of these findings.
DESIGN AND METHODS: In a randomized controlled trial (the DREAM-trial), 121 patients aged 18-40 years with MRI-verified meniscal tear were randomized to surgery or 12-weeks supervised exercise and patient education. For this exploratory study, the analyses were stratified by symptom onset (traumatic/non-traumatic). The main outcome was the difference in change after 12 months in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS4) subscales covering pain, symptoms, function in sport and recreation and quality of life.
RESULTS: Forty-two patients (69%) in the exercise therapy group and 47 (78%) in the surgery group were categorized as having a traumatic tear. We observed no difference in change in KOOS4 after 12 months between the two treatment groups for either traumatic tears (18.8 vs. 16.0 in the surgery vs. exercise therapy groups; adjusted mean difference, 4.8 [95% confidence interval, -1.7 to 11.2]) or non-traumatic tears (20.6 vs. 17.3 in the surgery vs. exercise therapy groups; adjusted mean difference, 7.0 [95% confidence interval, -3.7 to 17.7]).
CONCLUSION: In patients with traumatic and non-traumatic meniscus tears, early meniscal surgery did not appear superior to exercise and education in improving pain, function, and quality of life after 12-months. Further research is needed to confirm the clinical applicability of these findings.
| Original language | English |
|---|---|
| Journal | Journal of Orthopaedic and Sports Physical Therapy |
| Number of pages | 25 |
| ISSN | 0190-6011 |
| DOIs | |
| Publication status | E-pub ahead of print - 22 Feb 2024 |