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

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

ABSTRACT

Background: Previous evaluations of arthroscopic meniscal surgery showed little or no benefit in the short and midterm, but long-term effects were unknown.

Purpose: To compare the 10-year outcomes in middle-aged patients with meniscal symptoms between those who received an exercise program alone and those who received knee arthroscopy in addition to the exercise program, focusing on the prevalence of radiographic and symptomatic osteoarthritis (OA), patient-reported outcomes, and clinical status.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: 150 patients aged 45 to 64 were randomized to undergo either 3 months of exercise therapy (nonsurgery group) or knee arthroscopy in addition to exercise therapy (surgery group). Radiographs were assessed at baseline and 5- and 10-year follow-ups. Patient-reported outcome measures were reported at the baseline and 1-, 3-, 5-, and 10-year follow-ups. Clinical status was assessed at the 10-year follow-up. The primary outcomes were radiographic OA and changes in the Knee injury and Osteoarthritis Outcome Score Pain subscale (KOOSPAIN) from baseline to the 10-year follow-up.

Results: At the 10-year follow-up, knee arthroscopic surgery did not increase the rates of radiographic or symptomatic OA and resulted in similar patient-reported outcomes compared with exercise therapy alone.

Conclusion: Knee arthroscopic surgery, in addition to exercise therapy in middle-aged patients with meniscal symptoms, did not increase the rates of radiographic or symptomatic OA and resulted in similar patient-reported outcomes at the 10-year follow-up compared with exercise therapy alone.

Registration: Clinical Trials NCT01288768 (ClinicalTrials.gov identifier).

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