Effect of physical therapy vs arthroscopic partial meniscectomy in people with degenerative meniscal tears
| Autor: | Noorduyn, J.C.A., Graaf, V.A. van de, Willigenburg, N.W., Scholten-Peeters, G.G.M., Kret, E.J., Dijk, R.A. van, Buchbinder, R., Hawker, G.A., Coppieters, M.W., Poolman, R.W., ESCAPE Res Grp |
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| Přispěvatelé: | AMS - Rehabilitation & Development, Amsterdam Movement Sciences, Neuromechanics, AMS - Musculoskeletal Health |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Meniscectomy/adverse effects
Knee Injuries General Medicine Osteoarthritis Knee Middle Aged Tibial Meniscus Injuries Knee/surgery Tibial Meniscus Injuries/etiology SDG 3 - Good Health and Well-being Osteoarthritis Humans Female Osteoarthritis Knee/surgery Physical Therapy Modalities Meniscectomy Follow-Up Studies |
| Zdroj: | Noorduyn, J C A, Van De Graaf, V A, Willigenburg, N W, Scholten-Peeters, G G M, Kret, E J, Van Dijk, R A, Buchbinder, R, Hawker, G A, Coppieters, M W & Poolman, R W 2022, ' Effect of Physical Therapy vs Arthroscopic Partial Meniscectomy in People with Degenerative Meniscal Tears : Five-Year Follow-up of the ESCAPE Randomized Clinical Trial ', JAMA Network Open, vol. 5, no. 7, E2220394, pp. 1-15 . https://doi.org/10.1001/jamanetworkopen.2022.20394 Jama Network Open, 5(7). AMER MEDICAL ASSOC JAMA Network Open, 5(7):E2220394, 1-15. American Medical Association |
| ISSN: | 2574-3805 |
| DOI: | 10.1001/jamanetworkopen.2022.20394 |
| Popis: | Importance: There is a paucity of high-quality evidence about the long-term effects (ie, 3-5 years and beyond) of arthroscopic partial meniscectomy vs exercise-based physical therapy for patients with degenerative meniscal tears.Objectives: To compare the 5-year effectiveness of arthroscopic partial meniscectomy and exercise-based physical therapy on patient-reported knee function and progression of knee osteoarthritis in patients with a degenerative meniscal tear.Design, Setting, and Participants: A noninferiority, multicenter randomized clinical trial was conducted in the orthopedic departments of 9 hospitals in the Netherlands. A total of 321 patients aged 45 to 70 years with a degenerative meniscal tear participated. Data collection took place between July 12, 2013, and December 4, 2020.Interventions: Patients were randomly allocated to arthroscopic partial meniscectomy or 16 sessions of exercise-based physical therapy.Main Outcomes and Measures: The primary outcome was patient-reported knee function (International Knee Documentation Committee Subjective Knee Form (range, 0 [worst] to 100 [best]) during 5 years of follow-up based on the intention-to-treat principle, with a noninferiority threshold of 11 points. The secondary outcome was progression in knee osteoarthritis shown on radiographic images in both treatment groups.Results: Of 321 patients (mean [SD] age, 58 [6.6] years; 161 women [50.2%]), 278 patients (87.1%) completed the 5-year follow-up with a mean follow-up time of 61.8 months (range, 58.8-69.5 months). From baseline to 5-year follow-up, the mean (SD) improvement was 29.6 (18.7) points in the surgery group and 25.1 (17.8) points in the physical therapy group. The crude between-group difference was 3.5 points (95% CI, 0.7-6.3 points; P Conclusions and Relevance: In this noninferiority randomized clinical trial after 5 years, exercise-based physical therapy remained noninferior to arthroscopic partial meniscectomy for patient-reported knee function. Physical therapy should therefore be the preferred treatment over surgery for degenerative meniscal tears. These results can assist in the development and updating of current guideline recommendations about treatment for patients with a degenerative meniscal tear.Trial Registration: ClinicalTrials.gov Identifier: NCT01850719. |
| Databáze: | OpenAIRE |
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