Evidence map›Paper›PMID 27440192›Full record

Trial reportBMJ (Clinical research ed.)2016

Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up.

Nina Jullum Kise, May Arna Risberg, Silje Stensrud, Jonas Ranstam, Lars Engebretsen, Ewa M Roos

Erratum issued Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2016. 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 trial NCT01002794 (The Effect of Arthroscopic Partial Meniscectomy or Exercise Therapy as Treatment of Degenerative Meniscus Tears in Middle-aged Patients. A Randomized, Controlled Trial), which is not on this map. Cited by 110 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
110citing papers in PubMed, 14 pooled it
37.0field-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.

NCT01002794 nacompletednot on this map

The Effect of Arthroscopic Partial Meniscectomy or Exercise Therapy as Treatment of Degenerative Meniscus Tears in Middle-aged Patients. A Randomized, Controlled Trial

TypeinterventionalSponsorOslo University HospitalRan2009 to 2024Enrolled140ConditionsDegenerative Meniscal TearArmsArthroscopic partial menisectomy, Supervised neuromuscular and strength training
3 · Its place in the literature

Who cites it

110 citing papers in PubMed, 14 syntheses or guidelines pooled it, 297 citations in OpenAlex.

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  10. 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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50 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 3 countries.

Nina Jullum KiseDepartment of Orthopaedic Surgery, Martina Hansens Hospital, PO box 823, N-1306 Sandvika, Norway nina.kise@mhh.no.
May Arna RisbergNorwegian Research Centre for Active Rehabilitation, Oslo, Norway Division of Orthopaedic Surgery, Oslo University Hospital, Norway Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Silje StensrudNorwegian Research Centre for Active Rehabilitation, Oslo, Norway.
Jonas RanstamDepartment of Orthopaedics, Clinical Sciences Lund, Lund University, Sweden.
Lars EngebretsenDivision of Orthopaedic Surgery, Oslo University Hospital, Norway Faculty of Medicine, University in Oslo Oslo Sports Trauma Research Centre, Norwegian School of Sport Sciences, Oslo, Norway.
Ewa M RoosResearch Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
NORCE Research AS · NOLund University · SEMartina Hansens Hospital · NOUniversity of Oslo · NOUniversity of Southern Denmark · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears.

designRandomised controlled superiority trial.

settingOrthopaedic departments at two public hospitals and two physiotherapy clinics in Norway.

participants140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis.

interventions12 week supervised exercise therapy alone or arthroscopic partial meniscectomy alone.

main outcome measuresIntention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee related quality of life) from baseline to two year follow-up and change in thigh muscle strength from baseline to three months.

resultsNo clinically relevant difference was found between the two groups in change in KOOS4 at two years (0.9 points, 95% confidence interval -4.3 to 6.1; P=0.72). At three months, muscle strength had improved in the exercise group (P≤0.004). No serious adverse events occurred in either group during the two year follow-up. 19% of the participants allocated to exercise therapy crossed over to surgery during the two year follow-up, with no additional benefit.

conclusionThe observed difference in treatment effect was minute after two years of follow-up, and the trial's inferential uncertainty was sufficiently small to exclude clinically relevant differences. Exercise therapy showed positive effects over surgery in improving thigh muscle strength, at least in the short term. Our results should encourage clinicians and middle aged patients with degenerative meniscal tear and no definitive radiographic evidence of osteoarthritis to consider supervised exercise therapy as a treatment option.Trial registration www.clinicaltrials.gov (NCT01002794).

Indexed as

Muscle StrengthPainAdultArthroscopyExercise TherapyFemaleFollow-Up StudiesHumansKnee JointMagnetic Resonance ImagingMaleMiddle AgedNorwayPain MeasurementQuality of LifeSeverity of Illness Index

Identifiers

PMID27440192
PMCPMC4957588
OpenAlexW2485477398

What OpenQuestion holds

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LicenceCC BY-NC
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.