Skip to main content
SpringerLink
Log in

Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial

Knee Surgery, Sports Traumatology, Arthroscopy volume 15, pages 393–401 (2007)Cite this article

Abstract

In this prospective randomised study two treatments after non-traumatic medial meniscal tear diagnosed with radiological examination and magnetic resonance imaging were compared; arthroscopic partial meniscectomy followed by supervised exercise or supervised exercise alone. The aim was to evaluate knee function and physical activity. Ninety patients (mean age 56 years) were evaluated using the Knee Injury and Osteoarthritis Outcome Score, the Lysholm Knee Scoring Scale, the Tegner Activity Scale and a Visual Analogue Scale for knee pain prior to the intervention, after 8 weeks of exercise and after 6 months. According to the outcome scores arthroscopic partial medial meniscectomy combined with exercise did not lead to greater improvement than exercise alone. After the intervention both groups reported decreased knee pain, improved knee function and a high satisfaction (P < 0.0001). Forty-one per cent of the patients returned to their pre-injury activity level after 6 months. In conclusion, when evaluated with outcome scores, arthroscopic partial medial meniscectomy followed by supervised exercise was not superior to supervised exercise alone in terms of reduced knee pain, improved knee function and improved quality of life.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Aagaard H, Verdonk R (1999) Function of the normal meniscus and consequences of meniscal resection. Scand J Med Sci Sports 9:134–140

    Article  PubMed  CAS  Google Scholar 

  2. Ahlbäck S (1968) Osteoarthrosis of the knee. A radiographic investigation. Acta Radiologica 277(Suppl 277):7–72

    Google Scholar 

  3. Aichroth P (1996) Degenerative meniscal tears. Knee 3:70–72

    Article  Google Scholar 

  4. American College of Sports Medicine (ACSM) (2002) Progression models in resistance training for healthy adults. Med Sci Sports Exerc 34:364–380

    Google Scholar 

  5. Augustsson J (2001) Styrketräning vid rehabilitering. Sv Idr Forskn 3:65–71

    Google Scholar 

  6. Bengtsson J, Möllborg J, Werner S (1996) A study for testing the sensitivity and reliability of the Lysholm knee scoring scale. Knee Surg, Sports Traumatol, Arthrosc 4:27–31

    Article  CAS  Google Scholar 

  7. Bhattacharyya T et al (2003) The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee. J Bone Joint Surg Am 85:4–9

    PubMed  Google Scholar 

  8. Burks RT, Metcalf MH, Metcalf RW (1997) Fifteen-year follow-up of arthroscopic partial meniscectomy. J Arthroscopic Rel Surg 13:673–679

    Article  CAS  Google Scholar 

  9. Börjesson M, Robertson E, Weidenhielm L, Mattsson E, Olsson E (1996) Physiotherapy in knee osteoarthrosis: effect on pain and walking. Physiother Res Int 1:89–97

    PubMed  Google Scholar 

  10. Börjesson M, Karlsson J, Mannheimer C (2001) Mindre ont med motion. Läkartidningen 5:1786–1791

    Google Scholar 

  11. Cameron ML, Briggs KK, Steadman JR (2003) Reproducibility and reliability of the Outerbridge classification for grading chondral lesions of the knee arthroscopically. Am J Sports Med 31:83–86

    PubMed  Google Scholar 

  12. Chatain F, Robinson AH, Adeleine P, Chambat P, Neyret P (2001) The natural history of the knee following arthroscopic medial meniscectomy. Knee Surg Sports Traumatol Arthrosc 9(1):15–18

    Article  PubMed  CAS  Google Scholar 

  13. Desai VV, Ackroyd CE (2000) Resection of degenerate menisci—is it useful? Knee 7(3):179–182

    Article  PubMed  Google Scholar 

  14. Englund M, Roos EM, Roos HP, Lohmander LS (2001) Patient-relevant outcomes fourteen years after menisectomy: influence of type of meniscal tear and size of resection. Rheumatology 40:631–639

    Article  PubMed  CAS  Google Scholar 

  15. Feigenbaum M, Pollock M (1999) Prescription of resistance training for health and disease. Med Sci Sports Exerc 31:38–45

    Article  PubMed  CAS  Google Scholar 

  16. Fisher NM, Pendergast DR (1997) Reduced muscle function in patients with osteoarthritis. Scan J Rehab Med 29:213–221

    CAS  Google Scholar 

  17. Goodwin PC, Morrissey MC (2003) Physical therapy after arthroscopic partial menisectomy: is it effective? Exerc Sport Sci Rev 31(2):85–90

    Article  PubMed  Google Scholar 

  18. Goodwin PC, Morrissey MC, Omar RZ, Brown M, Southall K, McAuliffe TB (2003) Effectiveness of supervised physical therapy in the early period after arthroscopic partial meniscectomy. Phys Ther 6:521–535

    Google Scholar 

  19. Goodyear-Smith F, Arroll B (2001) Rehabilitation after arthroscopic meniscectomy: a critical review of the clinical trials. Int Orthop 24:350–353

    Article  PubMed  CAS  Google Scholar 

  20. Hamberg P, Gillquist J (1984) Knee function after arthroscopic meniscectomy. A prospective study. Acta Orthop Scand 55:172–175

    Article  PubMed  CAS  Google Scholar 

  21. Huskisson EL (1974) Measurement of pain. Lancet 9:1127–1131

    Article  Google Scholar 

  22. Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154

    PubMed  CAS  Google Scholar 

  23. Mangione KK, McCully K, Gloviak A, Lefebvre I, Hofman M, Craik R (1999) The effects of high-intensity and low-intensity cycle ergometry in older adults with knee osteoarthritis. J Gerontol A Biol Sci Med Sci 54:184–190

    Google Scholar 

  24. Marx RG et al (2001) Reliability, validity and responsiveness of four knee outcome scales for athletic patients. J Bone Surg (Am) 83:1459–1469

    Google Scholar 

  25. Marx RG et al (2005) Multirater agreement of arthroscopic grading of knee articular cartilage. Am J Sports Med 33:1654–1657

    Article  PubMed  Google Scholar 

  26. Matsusue Y, Thomson NL (1996) Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5- to 11-year followed-up study. Arthroscopy 12:39–44

    Article  PubMed  CAS  Google Scholar 

  27. Matthews P, St-Pierre DM (1996) Recovery of muscle strength following arthroscopic meniscectomy. J Orthop Sports Phys Ther 23(1):18–26

    PubMed  CAS  Google Scholar 

  28. Menetrey J, Siegrist O, Fritschy D (2002) Medial meniscectomy in patients over the age of fifty: a six year follow-up study. Swiss Surg 8:113–119

    Article  PubMed  CAS  Google Scholar 

  29. Moffet H, Richards CL, Maloin F, Bravo G, Paradis G (1994) Early and intensive physiotherapy accelerates recovery postarthroscopic meniscectomy: results of a randomized controlled study. Arch Phys Med Rehabil 75:415–426

    Article  PubMed  CAS  Google Scholar 

  30. Muellner T, Nikolie A, Vécsei V (1999) Recommendations for the diagnosis of traumatic meniscal injuries in athletes. Sports Med 27(5):337–345

    Article  PubMed  CAS  Google Scholar 

  31. Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg 43B:752–757

    Google Scholar 

  32. Pedersen BK, Saltin B (2006) Evidence for prescribing exercise as therapy in chronic disease. Scan J Med Sci Sports 16(Suppl1):3–63

    Article  Google Scholar 

  33. Petersson IF, Boegard T, Saxne T, Silman AJ, Svensson B (1997) Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35–54 years with chronic knee pain. Ann Rheum Dis 56(8):493–496

    PubMed  CAS  Google Scholar 

  34. Rangger C, Klestil T, Gloetzer W, Kemmler G, Benedetto KP (1995) Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 23(2):240–244

    PubMed  CAS  Google Scholar 

  35. Rangger C, Kathrein A, Klestil T, Gloetzer W (1997) Partial meniscectomy and osteoarthritis. Implications for treatment of athletes. Sports Med 23(1):61–68

    Article  PubMed  CAS  Google Scholar 

  36. Renström PAF (1995) Knee pain in tennis players. Clin Sports Med 14(1):163–175

    PubMed  Google Scholar 

  37. Risberg MA, Holm I, Steen H, Beynnon BD (1999) Sensitivity to changes over time for the IKDC form, the Lysholm score and the Cincinnati knee score: a prospective study of 120 ACL reconstructed patients with a 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 7(3):152–159

    Article  PubMed  CAS  Google Scholar 

  38. Rockborn P (2000) Clinical and radiographic outcome of meniscectomy and meniscus repair in the stable knee. Thesis. University of Linköping, Sweden

    Google Scholar 

  39. Roos EM, Roos HP, Ekdahl C, Lohmander LS (1998) Knee injury and osteoarthritis outcome score (KOOS)—validation of Swedish version. Scand J Med Sci Sports 8:439–448

    Article  PubMed  CAS  Google Scholar 

  40. Roos EM, Roos HP, Ryd L, Lohmander LS (2000) Substantial disability 3 months after arthroscopic partial meniscectomy: a prospective study of patient relevant outcomes. J Arthrosc Rel Surg 16(6):619–626

    Article  CAS  Google Scholar 

  41. Roos E (2002) Fysisk aktivitet kan påverka tidig artros. Läkartidningen 45(99):4484–4489

    Google Scholar 

  42. Roos E, Lohmander S (2003) The knee injury and osteoarthritis outcome score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 1:1–8

    Article  Google Scholar 

  43. Roos PH, Laurén M, Adalberth T, Roos EM, Jonsson K, Lohmander LS (1998) Knee osteoarthritis after meniscectomy. Arthritis Rheum 41:687–693

    Article  PubMed  CAS  Google Scholar 

  44. St-Pierre DM, Laforest S, Paradis S, Leroux M, Charron J, Racette Dalzell MA (1992) Isokinetic rehabilitation after arthroscopic meniscectomy. Eur J Appl Physiol 64(5):437–443

    Article  CAS  Google Scholar 

  45. St-Pierre D (1995) Rehabilitation following arthroscopic meniscectomy. Sports Med 20(5):338–347

    PubMed  CAS  Google Scholar 

  46. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop 198:43–49

    PubMed  Google Scholar 

  47. Vervest AM, Maurer CA, Schambergen TG, de Bie RA, Bulstra SK (1999) Effectiveness of physiotherapy after meniscectomy. Knee Surg Sports Traumatol Arthrosc 7(6):360–364

    Article  PubMed  CAS  Google Scholar 

  48. Weitzel PP, Richmond JC (2002) Critical evaluation of different scoring systems. Sports Med Arthrosc Review 10:183–190

    Article  Google Scholar 

  49. Who/Nut/Ncd (1998) Preventing and managing the global epidemic. Report of world health organization’s consultation on obesity, 3–5 June 1997, Geneva, World Health Organization

Download references

Author information

Authors and Affiliations

  1. Department of Physiotherapy, Rehabtjänst, S:t Eriksgatan 48, 112 34, Stockholm, Sweden

    Sylvia Herrlin

  2. Capio Artro Clinic, Stockholm Sports Trauma Research Center, Karolinska Institutet, Valhallavägen 91, 114 27, Stockholm, Sweden

    Maria Hållander, Peter Wange & Suzanne Werner

  3. Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76, Stockholm, Sweden

    Lars Weidenhielm

  4. Department of Orthopaedics, Karolinska Hospital, 171 76, Stockholm, Sweden

    Lars Weidenhielm

Authors
  1. Sylvia Herrlin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Hållander
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Wange
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lars Weidenhielm
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Suzanne Werner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sylvia Herrlin.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Herrlin, S., Hållander, M., Wange, P. et al. Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial. Knee Surg Sports Traumatol Arthrosc 15, 393–401 (2007). https://doi.org/10.1007/s00167-006-0243-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-006-0243-2

Keywords

search

Navigation