Knee Surgery vs Physical Therapy for Osteoarthritis
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial aims to determine whether surgery or physical therapy is more effective for individuals with knee osteoarthritis (OA) and a torn meniscus. The trial will compare arthroscopic partial meniscectomy (a type of knee surgery) with standard physical therapy sessions. Individuals who have experienced OA symptoms for at least a month and have issues like knee pain, popping, or clicking may be suitable candidates. Participants should have recent knee X-rays or MRIs showing a meniscal tear. The goal is to identify which treatment improves knee function and reduces pain. As an unphased trial, this study offers participants the chance to contribute to valuable research that could enhance treatment options for knee OA and meniscal tears.
Do I need to stop my current medications for the trial?
The trial protocol does not specify whether you need to stop taking your current medications. It seems that managing OA symptoms with medications is part of the inclusion criteria, so you may be able to continue them.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research has shown that arthroscopic partial meniscectomy (APM), a type of knee surgery, is usually well-tolerated, though some risks exist. One study found that only four out of 100 patients experienced poor results after the surgery. However, APM might slightly increase the risk of developing knee arthritis. Patients with meniscal tears in an already arthritic knee who underwent APM were nearly five times more likely to require additional surgery, such as a total knee replacement, compared to those who did not have the surgery.
While no specific studies on physical therapy are mentioned here, standard physical therapy is generally considered safe and is commonly used for knee problems. It typically includes exercises to strengthen and stretch the knee over several weeks.
In summary, APM carries some risks, such as the potential for increased arthritis or the need for further surgery, but many patients do well. Physical therapy remains a common and safe alternative for managing knee issues.12345Why are researchers excited about this trial?
Most treatments for knee osteoarthritis, like pain medications and lifestyle changes, focus on managing symptoms rather than directly addressing the knee structure. Researchers are excited about comparing knee surgery and physical therapy because these approaches tackle the problem differently. Arthroscopic partial meniscectomy (APM) surgery aims to directly repair the knee's internal structure, potentially offering longer-term relief by fixing the underlying issue. Meanwhile, standard physical therapy strengthens and stretches the knee, enhancing mobility and reducing pain without surgery. This trial could provide critical insights into which approach more effectively improves patients' quality of life.
What evidence suggests that this trial's treatments could be effective for knee osteoarthritis?
This trial will compare arthroscopic partial meniscectomy (APM) surgery with standard physical therapy for knee osteoarthritis. Research has shown that APM surgery often provides good short-term relief for knee pain, with most patients reporting significant improvements in pain and symptoms after one year. However, a small risk of developing knee osteoarthritis, a joint disease, exists after the surgery. In contrast, physical therapy, which participants in this trial may receive, also improves knee function and pain, though it might not be as effective in the long term compared to surgery. Both treatments are effective, with surgery offering quicker relief, while physical therapy remains a non-invasive option.12467
Who Is on the Research Team?
Jeffrey N Katz, MD
Principal Investigator
Brigham and Women's Hospital
Are You a Good Fit for This Trial?
This trial is for people with a specific knee problem where the cushioning cartilage (meniscus) is torn and they also have osteoarthritis. They must have had symptoms for at least a month, tried some treatments like meds or physical therapy, and be okay with being randomly assigned to treatment groups. People can't join if they've had previous knee surgery on the affected leg, are pregnant, have certain other joint diseases or severe arthritis needing total knee replacement.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are randomly assigned to either undergo APM surgery followed by physical therapy or receive standard physical therapy for 8 weeks
Follow-up
Participants are monitored for safety and effectiveness after treatment with regular visits and questionnaires
What Are the Treatments Tested in This Trial?
Interventions
- Arthroscopic partial menisectomy
- Postoperative rehabilitative physical therapy
- Standard physical therapy
Trial Overview
The study compares two common treatments for meniscal tears in patients with osteoarthritis: one group will undergo arthroscopic partial meniscectomy followed by rehab physical therapy; another group will receive standard physical therapy without surgery. The goal is to see which approach helps more.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Participants will undergo arthroscopic partial menisectomy (APM) surgery and offered postoperative rehabilitative physical therapy.
Participants will undergo standard physical therapy that will include strengthening and stretching sessions one to three times a week for 8 weeks.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Brigham and Women's Hospital
Lead Sponsor
Published Research Related to This Trial
Citations
Meniscectomy is associated with a higher rate of osteoarthritis ...
Meniscal repair is associated with a lower progression to knee osteoarthritis at approximately six years of follow-up compared to partial meniscectomy.
Arthroscopic Partial Meniscectomy in Patients With ...
At the 1-year follow-up, most patients achieved MCID: 73% in Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain, 66% in KOOS Symptoms, and 78% in KOOS ...
Effect of Physical Therapy vs Arthroscopic Partial ...
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 ...
Arthroscopic partial meniscectomy vs non-surgical or sham ...
Results: The APM group showed a small improvement over the non-surgical or sham group on knee pain at 24 months follow-up (2.5 points (95% CI: ...
Arthroscopic partial meniscectomy for a degenerative ...
APM was associated with a slightly increased risk of developing radiographic knee osteoarthritis and no concomitant benefit in patient-relevant outcomes, at 5 ...
On Patient Safety: Orthopaedic Surgeons Must Stop ...
Those authors found that patients treated with knee arthroscopy for meniscal tears in an arthritic joint were almost five times more likely to proceed to total ...
Clinical outcomes of arthroscopic partial meniscectomy at ...
The subjective assessment after surgery in our study indicated that only four patients out of 100 had poor results, whereas the remaining 96 ...
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