Effect of Physical Therapy vs Arthroscopic Partial Meniscectomy in People With Degenerative Meniscal Tears

Key Points Question Is exercise-based physical therapy noninferior to arthroscopic partial meniscectomy during a 5-year follow-up period in patients aged 45 to 70 years with a degenerative meniscal tear? Findings In this noninferiority randomized clinical trial, no significant or clinically relevant between-group difference in patient-reported knee function was noted on the International Knee Documentation Committee Subjective Knee Form at the 5-year follow-up. Physical therapy was not inferior to arthroscopic partial meniscectomy. Meaning The findings of this trial support the recommendation that exercise-based physical therapy should be the preferred treatment over surgery for degenerative meniscal tears.

• Publication year

  2022

• Venue

  JAMA Network Open

• Publication date

  2022-07-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1001/jamanetworkopen.2022.20394PMID 35802374PMCID 9270699
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• An individualized decision between physical therapy or surgery for patients with degenerative meniscal tears cannot be based on continuous treatment selection markers: a marker-by-treatment analysis of the ESCAPE study

  2022cited by this paper
• Efficacy and safety of radiofrequency treatment for improving knee pain and function in knee osteoarthritis: a meta-analysis of randomized controlled trials

  2022cited by this paper
• In patients eligible for meniscal surgery who first receive physical therapy, multivariable prognostic models cannot predict who will eventually undergo surgery

  2021cited by this paper
• Knee Arthroscopic Surgery in Middle-Aged Patients With Meniscal Symptoms: A 5-Year Follow-up of a Prospective, Randomized Study

  2020cited by this paper
• Dutch Guideline on Knee Arthroscopy Part 1, the meniscus: a multidisciplinary review by the Dutch Orthopaedic Association

  2020cited by this paper
• Arthroscopic partial meniscectomy for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial

  2020cited by this paper
• Development of osteoarthritis in patients with degenerative meniscal tears treated with exercise therapy or surgery. A randomized controlled trial.

  2020cited by this paper
• Five‐Year Outcome of Operative and Nonoperative Management of Meniscal Tear in Persons Older Than Forty‐Five Years

  2020cited by this paper
• Responsiveness and Minimal Important Change of the IKDC of Middle-Aged and Older Patients With a Meniscal Tear

  2019cited by this paper
• Arthroscopic partial meniscectomy for meniscal tears of the knee: a systematic review and meta-analysis

  2019cited by this paper
• Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement.

  2019cited by this paper
• Wild goose chase – no predictable patient subgroups benefit from meniscal surgery: patient-reported outcomes of 641 patients 1 year after surgery

  2019cited by this paper
• Changes in the rate of publicly financed knee arthroscopies: an analysis of data from the Norwegian patient registry from 2012 to 2016

  2018cited by this paper
• Effect of Early Surgery vs Physical Therapy on Knee Function Among Patients With Nonobstructive Meniscal Tears: The ESCAPE Randomized Clinical Trial

  2018cited by this paper
• Patient Acceptable Symptom State in Knee Osteoarthritis Patients Succeeds Across Different Patient-reported Outcome Measures Assessing Physical Function, But Fails Across Other Dimensions and Rheumatic Diseases

  2018cited by this paper
• Knee Osteoarthritis after Arthroscopic Partial Meniscectomy: Prevalence and Progression of Radiographic Changes after 5 to 12 Years Compared with Contralateral Knee

  2018cited by this paper
• A controlled before-after study to evaluate the effect of a clinician led policy to reduce knee arthroscopy in NSW

  2018cited by this paper
• Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review

  2017cited by this paper
• Surgical Management of Degenerative Meniscus Lesions: The 2016 ESSKA Meniscus Consensus

  2017cited by this paper
• Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline

  2017cited by this paper
• Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus

  2017cited by this paper
• Changes Within Clinical Practice After a Randomized Controlled Trial of Knee Arthroscopy for Osteoarthritis

  2017cited by this paper
• Meniscus surgery is still widely performed in the treatment of degenerative meniscus tears in The Netherlands

  2017cited by this paper
• Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

  2016cited by this paper
• Predictors and Outcomes of Crossover to Surgery from Physical Therapy for Meniscal Tear and Osteoarthritis: A Randomized Trial Comparing Physical Therapy and Surgery.

  2016cited by this paper
• Cost-effectiveness of Early Surgery versus Conservative Treatment with Optional Delayed Meniscectomy for Patients over 45 years with non-obstructive meniscal tears (ESCAPE study): protocol of a randomised controlled trial

  2016cited by this paper
• Arthroscopy for Knee Osteoarthritis Has Not Decreased After a Clinical Trial

  2016cited by this paper
• Knee arthroscopic surgery is beneficial to middle-aged patients with meniscal symptoms: a prospective, randomised, single-blinded study.

  2014cited by this paper
• Surgery versus physical therapy for a meniscal tear and osteoarthritis.

  2013influential reference
• Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up

  2013cited by this paper
• Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear.

  2013cited by this paper
• A Comparative Study of Meniscectomy and Nonoperative Treatment for Degenerative Horizontal Tears of the Medial Meniscus

  2013cited by this paper
• Meniscus pathology, osteoarthritis and the treatment controversy

  2012cited by this paper
• Psychometric properties of the OARSI/OMERACT osteoarthritis pain and functional impairment scales: ICOAP, KOOS-PS and HOOS-PS.

  2011cited by this paper
• A randomized trial of arthroscopic surgery for osteoarthritis of the knee.

  2008cited by this paper
• The development of a short measure of physical function for knee OA KOOS-Physical Function Shortform (KOOS-PS) - an OARSI/OMERACT initiative.

  2008cited by this paper
• Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial

  2007cited by this paper
• Reliability, validity, and responsiveness of the IKDC score for meniscus injuries of the knee.

  2007cited by this paper
• Atlas of individual radiographic features in osteoarthritis, revised.

  2007cited by this paper
• A controlled trial of arthroscopic surgery for osteoarthritis of the knee

  2005influential reference
• Development and Validation of the International Knee Documentation Committee Subjective Knee Form *

  2001cited by this paper
• Arthroscopic evaluation of knee articular cartilage: a comparison with plain radiographs and magnetic resonance imaging.

  1994cited by this paper
• EuroQol--a new facility for the measurement of health-related quality of life.

  1990cited by this paper
• Radiological Assessment of Osteo-Arthrosis

  1957cited by this paper

• Advances in the Diagnosis and Treatment of Meniscal Tears

  2026cites this paper
• Managing the meniscus part I-Anatomy, biomechanics, and treatment strategies for the atraumatic meniscus tear.

  2026cites this paper
• Long-term outcome of high tibial osteotomy for canine cranial cruciate ligament disease without stifle exploration: an observational study of 236 stifles.

  2026cites this paper
• Global trends and research landscape of arthroscopic therapy and exercise rehabilitation in meniscal tear: a bibliometric analysis

  2025cites this paper
• Physical therapy vs. glucocorticoid injection in patients with meniscal tears and knee osteoarthritis: a multi-center, randomized, controlled trial

  2025cites this paper
• World Report: A Snapshot of Orthopaedic Surgery in The Netherlands

  2025cites this paper
• Arthroscopic meniscal surgery vs non-operative treatment for degenerative tears with mechanical symptoms: 5-year outcomes systematic review and meta-analysis of RCTs

  2025cites this paper
• Secretome from human placenta-derived mesenchymal stem cells repairs mechanically induced meniscus injury in mice by activating the proliferation and suppressing the apoptosis of endogenous meniscus progenitor cells

  2025cites this paper
• Early Meniscal Repair Leads to Higher Success Rates Than Delayed Meniscal Repair: A Systematic Review and Meta-analysis

  2025cites this paper
• The Meniscus: Basic Science and Therapeutic Approaches

  2025cites this paper
• Evaluation of radiographic knee OA progression after arthroscopic meniscectomy compared with IACI for degenerative meniscus tear

  2025cites this paper
• Horizontal cleavage and radial meniscus tears: a review of treatment options, surgical techniques and outcomes

  2025cites this paper
• Ultrasound-Guided Meniscal Injection of Autologous Conditioned Plasma: a case series at middle term evaluation

  2025cites this paper
• Socioeconomic and Demographic Variables Are Lacking in Meniscectomy Randomized Controlled Trials: A Systematic Review.

  2025cites this paper
• Postoperative Rehabilitation and Functional Recovery After Knee Meniscectomy: An Ambispective Cohort Study

  2025cites this paper
• Quality Performance Management in the Tuscany Procurement and Transplant System: A Reporting and Monitoring Approach.

  2025cites this paper
• ARTHROSCOPIC PARTIAL MENISCECTOMY

  2025cites this paper
• Debridement of Unstable Chondral Lesions During Arthroscopic Partial Meniscectomy Provides No Long-Term Benefit: Patient Outcomes 9 Years After the Original ChAMP Trial.

  2025cites this paper
• The applied study to improve the treatment of knee sports injuries in ultimate frisbee players based on personalized exercise prescription: a randomized controlled trial

  2024cites this paper
• Meniscectomy Reimbursement and Utilization is Declining at Different Rates Across the United States.

  2024cites this paper
• The impact of physiotherapy interventions on enhancing wound healing post knee osteoarthritis surgery: A meta‐analysis

  2024cites this paper
• Arthroscopic Partial Meniscectomy in Patients With Kellgren-Lawrence Grade 3 Osteoarthritis Shows Clinically Meaningful Improvement in Outcomes

  2024cites this paper
• Long-term effects of exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear: A meta-analysis of randomized controlled trials.

  2024cites this paper
• Meniscal Comma Sign Responds to Partial Meniscectomy Despite Increased Levels of Arthritis

  2024cites this paper
• The Role of Ultrasound in the Diagnosis and Treatment of Meniscal Injuries

  2024cites this paper
• Most Major Hospitals Fail to Comply with Federal Price Transparency Regulations.

  2024cites this paper
• Higher odds of meniscectomy compared with meniscus repair in a young patient population with increased neighbourhood disadvantage

  2024cites this paper
• Surgical Therapy and Tissue Engineering for Meniscal Repair

  2024cites this paper
• Knee Arthroscopic Surgery in Middle-Aged Patients With Meniscal Symptoms: A 10-Year Follow-up of a Prospective, Randomized Controlled Trial

  2024cites this paper
• Decreasing Incidence of Partial Meniscectomy, and Increasing Incidence of Meniscus Preservation Surgery from 2010-2020 in the United States.

  2024cites this paper
• Arthroscopic surgery is not superior to conservative treatment in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trails

  2024cites this paper
• Arthroscopic partial meniscectomy versus exercise therapy for degenerative meniscal tears: 10-year follow-up of the OMEX randomised controlled trial

  2024cites this paper
• Clinical Outcomes of Exercise Rehabilitation for Degenerative Tibial Meniscal Tears: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  2024cites this paper
• Characterizing Treatment Credibility, Treatment Expectancy, and Symptom Expectancy in Patients Before Nonoperative Treatment for Degenerative Meniscal Tears

  2024cites this paper
• The worn knee

  2024cites this paper
• Atualização no tratamento das lesões meniscais

  2023cites this paper
• Preoperative Predictors of Patient-Reported Outcomes Following Arthroscopic Partial Meniscectomy

  2023cites this paper
• The efficacy of extracorporeal shock wave combined with platelet rich plasma in the treatment of knee osteoarthritis with meniscus injury: A retrospective analysis

  2023cites this paper
• Short-term transplantation effect of a tissue-engineered meniscus constructed using drilled allogeneic acellular meniscus and BMSCs

  2023cites this paper
• OARSI Year in Review 2023: Rehabilitation and Outcomes.

  2023cites this paper
• High survival rate after the combination of intrameniscal and intraarticular infiltrations of platelet-rich plasma as conservative treatment for meniscal lesions

  2023cites this paper
• What's New in Sports Medicine.

  2023cites this paper
• Degenerativer Meniskusriss: Alleinige Physiotherapie scheint einer arthroskopischen Behandlung nicht unterlegen zu sein

  2023cites this paper
• Update on Meniscal Injury Treatment

  2023cites this paper
• Arthroscopic Treatment of Degenerative Meniscal Tears and Sham Surgery or Physical Therapy-an Update on the ESCAPE Trial.

  2022cites this paper
• Hidden Unstable Flap Should Be Suspected in Treating Intractable Pain from Medial Meniscus Horizontal Tear

  2022cites this paper
• Study Examines Physical Therapy Versus Surgery for Degenerative Meniscal Tears

  2022cites this paper
• Knee

  2022cites this paper