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
| Autor: | Raine, Sihvonen, Mika, Paavola, Antti, Malmivaara, Ari, Itälä, Antti, Joukainen, Juha, Kalske, Heikki, Nurmi, Jaanika, Kumm, Niko, Sillanpää, Tommi, Kiekara, Aleksandra, Turkiewicz, Pirjo, Toivonen, Martin, Englund, Simo, Taimela, Teppo L N, Järvinen, Ville, Äärimaa |
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| Přispěvatelé: | FICEBO, University of Helsinki, HUS Musculoskeletal and Plastic Surgery, I kirurgian klinikka (Töölö), Department of Surgery, Helsinki University Hospital Area, Tampere University, Verisuoni- ja toimenpideradiologinen keskus, Clinical Medicine, Department of Radiology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Osteoarthritis
law.invention Arthroscopy 0302 clinical medicine Postoperative Complications Randomized controlled trial meniscus law Risk Factors Orthopedics and Sports Medicine 030212 general & internal medicine 315 Sport and fitness sciences Finland Original Research Lysholm Knee Score MIDDLE-AGED PATIENTS Absolute risk reduction General Medicine Osteoarthritis Knee Middle Aged MECHANICAL SYMPTOMS Magnetic Resonance Imaging 3. Good health Tibial Meniscus Injuries medicine.anatomical_structure RELIABILITY Disease Progression medicine.symptom Medial meniscus Adult medicine.medical_specialty VERTEBROPLASTY Physical Therapy Sports Therapy and Rehabilitation KNEE OSTEOARTHRITIS Placebo 3121 Internal medicine CLASSIFICATION 03 medical and health sciences medicine Humans Patient Reported Outcome Measures Aged Meniscectomy Surgeons business.industry MEDICINE 030229 sport sciences CARE medicine.disease RANDOMIZED-TRIAL Surgery Radiography PATHOLOGY osteoarthritis Knee pain Orthopedic surgery business Follow-Up Studies |
| Zdroj: | British Journal of Sports Medicine |
| ISSN: | 1473-0480 0306-3674 0105-2233 |
| Popis: | ObjectivesTo assess the long-term effects of arthroscopic partial meniscectomy (APM) on the development of radiographic knee osteoarthritis, and on knee symptoms and function, at 5 years follow-up.DesignMulticentre, randomised, participant- and outcome assessor-blinded, placebo-surgery controlled trial.SettingOrthopaedic departments in five public hospitals in Finland.Participants146 adults, mean age 52 years (range 35–65 years), with knee symptoms consistent with degenerative medial meniscus tear verified by MRI scan and arthroscopically, and no clinical signs of knee osteoarthritis were randomised.InterventionsAPM or placebo surgery (diagnostic knee arthroscopy).Main outcome measuresWe used two indices of radiographic knee osteoarthritis (increase in Kellgren and Lawrence grade ≥1, and increase in Osteoarthritis Research Society International (OARSI) atlas radiographic joint space narrowing and osteophyte sum score, respectively), and three validated patient-relevant measures of knee symptoms and function (Western Ontario Meniscal Evaluation Tool (WOMET), Lysholm, and knee pain after exercise using a numerical rating scale).ResultsThere was a consistent, slightly greater risk for progression of radiographic knee osteoarthritis in the APM group as compared with the placebo surgery group (adjusted absolute risk difference in increase in Kellgren-Lawrence grade ≥1 of 13%, 95% CI −2% to 28%; adjusted absolute mean difference in OARSI sum score 0.7, 95% CI 0.1 to 1.3). There were no relevant between-group differences in the three patient-reported outcomes: adjusted absolute mean differences (APM vs placebo surgery), −1.7 (95% CI −7.7 to 4.3) in WOMET, −2.1 (95% CI −6.8 to 2.6) in Lysholm knee score, and −0.04 (95% CI −0.81 to 0.72) in knee pain after exercise, respectively. The corresponding adjusted absolute risk difference in the presence of mechanical symptoms was 18% (95% CI 5% to 31%); there were more symptoms reported in the APM group. All other secondary outcomes comparisons were similar.ConclusionsAPM was associated with a slightly increased risk of developing radiographic knee osteoarthritis and no concomitant benefit in patient-relevant outcomes, at 5 years after surgery.Trial registrationClinicalTrials.gov (NCT01052233andNCT00549172). |
| Databáze: | OpenAIRE |
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