Arthroscopic partial meniscectomy versus exercise therapy for degenerative meniscal tears: 10-year follow-up of the OMEX randomised controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(5):42 Br J Sports Med. 2025 Jan 2;59(2):91-98.What this means for my practice?
Exercise therapy should be the preferred treatment over APM for middle-aged individuals with degenerative meniscal tears, as both treatments result in similar long-term outcomes. Clinicians should prioritize exercise-based rehabilitation to avoid unnecessary surgery. A limitation of this study is the relatively high loss to follow-up, particularly in the exercise group, which may have influenced the results.
Study Summary
One hundred forty patients with degenerative meniscal tears and minimal knee OA were randomized to receive either arthroscopic partial meniscectomy (APM) (n=70) or 12 weeks of exercise therapy (n=70). The primary outcome of interest was knee OA progression, assessed by the Osteoarthritis Research Society International (OARSI) atlas sum score. Secondary outcomes included the incidence of radiographic and symptomatic knee OA, patient-reported pain and knee function, and isokinetic knee muscle strength. Outcomes were assessed over a 10-year follow-up period. Overall, the results of the study revealed no meaningful differences between groups in radiographic knee OA progression or OA development. Both treatments led to substantial and sustained improvements in patient-reported pain and knee function. These findings suggest that exercise therapy should be the preferred treatment over APM for degenerative meniscal tears.
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