Patients with degenerative meniscal tears and osteoarthritis (OA)-related changes in the knee will usually experience pain relief over 5 years whether they receive physical therapy or undergo arthroscopic partial menisectomy, researchers suggest.
The data was presented recently at the 2018 American College of Rheumatology and Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting.
In the study, researchers from Brigham and Women’s Hospital and Harvard Medical School in Boston conducted a multicenter, randomized trial to assess the 5-year outcomes for patients with OA-related knee pain and meniscal tear. They enrolled 351 participants with knee pain, meniscal tear, and OA changes on x-ray or magnetic resonance imaging (MRI), according to Rheumatology Advisor.
Participants were randomly assigned to receive 5 years of physical therapy or physical therapy plus arthroscopic partial meniscectomy. The primary end point was pain, measured using the Knee Osteoarthritis and Injury Outcome Score Pain Scale. Scores ranged from 0-100, with 100 being the worst pain.
A total of 164 participants were randomly assigned to receive surgery, 109 were assigned to and received physical therapy, and 68 were assigned to physical therapy and crossed over to receive surgery.
Results showed similar pain improvements among all three treatment groups, with pain scores of 40-50 improving to 20-25 by 6 months. Researchers noted that pain scores showed little change between 6 and 60 months.
Twenty-five patients had a total knee replacement during the follow-up period, and 10% of those who received arthroscopic partial meniscectomy, either immediately or after crossover, had total knee replacement compared with 2% of participants who received physical therapy with no surgery, Rheumatology Advisor explains.
“For clinicians, these results suggest that patients with meniscal tear and osteoarthritic changes can be reassured that they are likely to experience improvement with either surgery or [physical therapy],” states study coauthor Jeffrey N. Katz, MD, MSc, professor of medicine and orthopedic surgery at Harvard Medical School, in the release. “For researchers, the increased rates of knee replacement require more detailed study.”
[Source: Rheumatology Advisor]