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.