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• W2415053919 abstract "IntroductionRecent evidence has shown that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment for patients with a degenerative meniscus tear. However, it has been alleged that patients reporting mechanical symptoms (sensations of knee catching or locking) may benefit from APM. Therefore, the objective of this study was to assess whether APM improves mechanical symptoms better than placebo-surgery.MethodsIn this double-blind placebo-surgery controlled randomized multicenter trial, participants with degenerative medial meniscus tear and no knee osteoarthritis were randomly assigned (1:1) to arthroscopic partial meniscectomy (APM) or placebo surgery (diagnostic arthroscopy). Participants’ self-report of mechanical symptoms was assessed using the 'Locking-domain' of the Lysholm score preoperatively and two, six, and twelve months postoperatively. The risk of having mechanical symptoms after APM vs. placebo surgery was determined in the complete sample and in the subgroup of patients with preoperative mechanical symptoms.Results70 participants were randomly assigned to APM and 76 to placebo-surgery. Thirty-two (46%) participants in the APM arm and 37 (49%) in the placebo-surgery arm reported catching or locking preoperatively. The corresponding numbers at any of the three follow-up occasions were 34 (49%) and 33 (43%) respectively, a risk difference (APM vs. placebo-surgery) of 0.03 (95% CI -0.06 to 0.12). In the subgroup of 69 participants with preoperative catching or locking, the corresponding risk difference was 0.07 (95% CI -0.08 to 0.22).ConclusionThe resection of a torn meniscus provides no added benefit to placebo-surgery in relieving knee catching or occasional locking. Our findings question whether these symptoms are caused by a degenerative meniscus tear and also prompt caution in using patients’ self-report of these symptoms as an indication for performing APM. IntroductionRecent evidence has shown that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment for patients with a degenerative meniscus tear. However, it has been alleged that patients reporting mechanical symptoms (sensations of knee catching or locking) may benefit from APM. Therefore, the objective of this study was to assess whether APM improves mechanical symptoms better than placebo-surgery. Recent evidence has shown that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment for patients with a degenerative meniscus tear. However, it has been alleged that patients reporting mechanical symptoms (sensations of knee catching or locking) may benefit from APM. Therefore, the objective of this study was to assess whether APM improves mechanical symptoms better than placebo-surgery. MethodsIn this double-blind placebo-surgery controlled randomized multicenter trial, participants with degenerative medial meniscus tear and no knee osteoarthritis were randomly assigned (1:1) to arthroscopic partial meniscectomy (APM) or placebo surgery (diagnostic arthroscopy). Participants’ self-report of mechanical symptoms was assessed using the 'Locking-domain' of the Lysholm score preoperatively and two, six, and twelve months postoperatively. The risk of having mechanical symptoms after APM vs. placebo surgery was determined in the complete sample and in the subgroup of patients with preoperative mechanical symptoms. In this double-blind placebo-surgery controlled randomized multicenter trial, participants with degenerative medial meniscus tear and no knee osteoarthritis were randomly assigned (1:1) to arthroscopic partial meniscectomy (APM) or placebo surgery (diagnostic arthroscopy). Participants’ self-report of mechanical symptoms was assessed using the 'Locking-domain' of the Lysholm score preoperatively and two, six, and twelve months postoperatively. The risk of having mechanical symptoms after APM vs. placebo surgery was determined in the complete sample and in the subgroup of patients with preoperative mechanical symptoms. Results70 participants were randomly assigned to APM and 76 to placebo-surgery. Thirty-two (46%) participants in the APM arm and 37 (49%) in the placebo-surgery arm reported catching or locking preoperatively. The corresponding numbers at any of the three follow-up occasions were 34 (49%) and 33 (43%) respectively, a risk difference (APM vs. placebo-surgery) of 0.03 (95% CI -0.06 to 0.12). In the subgroup of 69 participants with preoperative catching or locking, the corresponding risk difference was 0.07 (95% CI -0.08 to 0.22). 70 participants were randomly assigned to APM and 76 to placebo-surgery. Thirty-two (46%) participants in the APM arm and 37 (49%) in the placebo-surgery arm reported catching or locking preoperatively. The corresponding numbers at any of the three follow-up occasions were 34 (49%) and 33 (43%) respectively, a risk difference (APM vs. placebo-surgery) of 0.03 (95% CI -0.06 to 0.12). In the subgroup of 69 participants with preoperative catching or locking, the corresponding risk difference was 0.07 (95% CI -0.08 to 0.22). ConclusionThe resection of a torn meniscus provides no added benefit to placebo-surgery in relieving knee catching or occasional locking. Our findings question whether these symptoms are caused by a degenerative meniscus tear and also prompt caution in using patients’ self-report of these symptoms as an indication for performing APM. The resection of a torn meniscus provides no added benefit to placebo-surgery in relieving knee catching or occasional locking. Our findings question whether these symptoms are caused by a degenerative meniscus tear and also prompt caution in using patients’ self-report of these symptoms as an indication for performing APM." @default.
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• W2415053919 title "Mechanical Symptoms and Arthroscopic Partial Meniscectomy in Patients with Degenerative Meniscus Tear: A Secondary Analysis of a Randomized, Placebo-controlled Trial" @default.
• W2415053919 doi "https://doi.org/10.1016/j.arthro.2016.03.087" @default.
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