Evidence map›Paper›PMID 23506518›Full record

Trial reportThe New England journal of medicine2013

Surgery versus physical therapy for a meniscal tear and osteoarthritis.

Jeffrey N Katz, Robert H Brophy, Christine E Chaisson, Leigh de Chaves, Brian J Cole, Diane L Dahm, Laurel A Donnell-Fink, Ali Guermazi, Amanda K Haas, Morgan H Jones and 19 more

Erratum issued 3 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 268 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
268citing papers in PubMed, 22 pooled it
51.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00597012 nacompletednot on this map

Partial Meniscectomy Versus Nonoperative Management in Meniscal Tear With OA: A Randomized Controlled Trial (MeTeOR)

TypeinterventionalSponsorBrigham and Women's HospitalRan2008 to 2025Enrolled351ConditionsOsteoarthritisArmsArthroscopic partial menisectomy, Standard physical therapy, Postoperative rehabilitative physical therapy
NCT03120988 phase1completednot on this mapstarted 2016, after this paper: background citation

Assessing Catabolic Marker Levels in the Knee Synovial Fluid Microenvironment After Lavage With Platelet Poor Plasma (PPP)

TypeinterventionalSponsorRegenexx, LLCRan2016 to 2017Enrolled10ConditionsKnee OsteoarthritisArmsLavage with Platelet Poor Plasma (PPP)
NCT03909178 naactive not recruitingnot on this map

Arthroscopic Labral Repair Versus Physical Therapy for Tears of the Acetabular Labrum in Patients Age 40 and Older

TypeinterventionalSponsorMassachusetts General HospitalRan2013 to 2030Enrolled110ConditionsAcetabular Labrum Tear, Femoro Acetabular Impingement, Hip Arthroscopy, Physical TherapyArmsHip Arthroscopy Surgery with Acetabular Labral Repair (SPT group), Physical Therapy Focused on the Hip and Hemi-pelvis (PT group)
3 · Its place in the literature

Who cites it

268 citing papers in PubMed, 22 syntheses or guidelines pooled it, 648 citations in OpenAlex.

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  16. Surgical interventions for symptomatic mild to moderate knee osteoarthritis.The Cochrane database of systematic reviews · 2019
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  17. Guideline
  18. Subgroups of patients with osteoarthritis and medial meniscus tear or crystal arthropathy benefit from arthroscopic treatment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019
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208 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

29 authors at 7 institutions in 1 country.

Jeffrey N KatzOrthopedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA. jnkatz@partners.org.
Robert H Brophy
Christine E Chaisson
Leigh de Chaves
Brian J Cole
Diane L Dahm
Laurel A Donnell-Fink
Ali Guermazi
Amanda K Haas
Morgan H Jones
Bruce A Levy
Lisa A Mandl
Scott D Martin
Robert G Marx
Anthony Miniaci
Matthew J Matava
Joseph Palmisano
Emily K Reinke
Brian E Richardson
Benjamin N Rome
Clare E Safran-Norton
Debra J Skoniecki
Daniel H Solomon
Matthew V Smith
Kurt P Spindler
Michael J Stuart
John Wright
Rick W Wright
Elena Losina
Brigham and Women's Hospital · USWashington University in St. Louis · USMayo Clinic in Arizona · USVanderbilt University · USCleveland Clinic · USHospital for Special Surgery · USRush University · US

Funding

Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
Trial of risk mangement for prevention of accelerated atherosclerosis in SLEP60AR047782 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI KATZ, JEFFREY NEIL · 2001 to 2016
$18.8M
PARTIAL MENISCECTOMY VS. NONOPERATIVE MGMT. IN MENISCAL TEAR WITH OA: AN RCTR01AR055557 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI KATZ, JEFFREY NEIL · 2007 to 2023
$11.2M
Patient Oriented Research and Mentoring Program in OrthopedicsK24AR057827 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI LOSINA, ELENA · 2010 to 2019
$1.7M
NCATS NIH HHS UL1 TR000448NIAMS NIH HHS K24 AR057827NIAMS NIH HHS K24AR057827NIAMS NIH HHS P60 AR047782NIAMS NIH HHS P60AR047782NIAMS NIH HHS R01 AR055557NIAMS NIH HHS R01AR055557
6 · The paper itself

Abstract

backgroundWhether arthroscopic partial meniscectomy for symptomatic patients with a meniscal tear and knee osteoarthritis results in better functional outcomes than nonoperative therapy is uncertain.

methodsWe conducted a multicenter, randomized, controlled trial involving symptomatic patients 45 years of age or older with a meniscal tear and evidence of mild-to-moderate osteoarthritis on imaging. We randomly assigned 351 patients to surgery and postoperative physical therapy or to a standardized physical-therapy regimen (with the option to cross over to surgery at the discretion of the patient and surgeon). The patients were evaluated at 6 and 12 months. The primary outcome was the difference between the groups with respect to the change in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical-function score (ranging from 0 to 100, with higher scores indicating more severe symptoms) 6 months after randomization.

resultsIn the intention-to-treat analysis, the mean improvement in the WOMAC score after 6 months was 20.9 points (95% confidence interval [CI], 17.9 to 23.9) in the surgical group and 18.5 (95% CI, 15.6 to 21.5) in the physical-therapy group (mean difference, 2.4 points; 95% CI, -1.8 to 6.5). At 6 months, 51 active participants in the study who were assigned to physical therapy alone (30%) had undergone surgery, and 9 patients assigned to surgery (6%) had not undergone surgery. The results at 12 months were similar to those at 6 months. The frequency of adverse events did not differ significantly between the groups.

conclusionsIn the intention-to-treat analysis, we did not find significant differences between the study groups in functional improvement 6 months after randomization; however, 30% of the patients who were assigned to physical therapy alone underwent surgery within 6 months. (Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases; METEOR ClinicalTrials.gov number, NCT00597012.).

Indexed as

Physical Therapy ModalitiesTibial Meniscus InjuriesFemaleHumansIntention to Treat AnalysisKnee InjuriesMaleMenisci, TibialMiddle AgedOsteoarthritis, KneePain MeasurementPostoperative ComplicationsRecovery of FunctionSeverity of Illness Index

Identifiers

PMID23506518
PMCPMC3690119
OpenAlexW2098656787

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.