Long-term consequences of degenerative meniscal tears in middle-aged patients

Abstract

Degenerative meniscal tears represent an early sign of knee osteoarthritis. Arthroscopic partial menis-cectomy has been the usual treatment for symptomatic tears, but studies have shown no additional benefit compared to exercise therapy up to two years following treatment. In this thesis, “Long-term consequences of degenerative meniscal tears in middle-aged patients”, ar-throscopic partial meniscectomy was compared to exercise therapy in a five-year follow-up of a ran-domized controlled trial including 140 patients. No between-group differences in progression of radiographic knee osteoarthritis changes were found over five years. Both treatment groups had clinically relevant improvements in patient-reported pain and knee function, but neither treatment was superior. Exercise therapy effectively improved knee muscle strength up to 12 months compared to arthroscopic partial meniscectomy. Quadriceps muscle weakness at study inclusion was a risk factor for knee osteoarthritis progression over five years. The results of this thesis support the ongoing change in treatment strategy for degenerative meniscal tears, recommending exercise therapy over surgery as the first-line treatment.