Meniscal procedures are not increased with delayed ACL reconstruction and rehabilitation: results from a randomised controlled trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(5):38 Br J Sports Med. 2023 Jan;57(2):78-82.What this means for my practice?
In young patients with isolated traumatic meniscal tears, early arthroscopic partial meniscectomy does not yield better functional outcomes than a strategy of initial physical therapy with an option for delayed surgery. These findings suggest that conservative management should be considered first. The study's main limitation is the lack of blinding and potential selection bias due to patient treatment preferences.
Study Summary
One hundred patients with isolated traumatic meniscal tears were randomized to receive either arthroscopic partial meniscectomy (n=49) or standardized physical therapy (n=51), with the option for delayed arthroscopic partial meniscectomy after three months. The primary outcome was the IKDC score at 24 months, which assesses knee symptoms, function, and ability to participate in sports. Secondary outcomes included KOOS, NRS pain, Lysholm, WOMET, Tegner activity level, and satisfaction with knee function. Follow-up assessments were conducted at multiple time points up to 24 months. Overall, both groups demonstrated clinically relevant improvements in IKDC scores, but there was no significant difference between the groups at 24 months. The study suggests that physical therapy with optional delayed surgery is a reasonable alternative to early arthroscopic partial meniscectomy.
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