Research, like that below, are suggesting that exercise / physical therapy provides comparable or better long-term benefits to arthroscopic partial meniscectomy.
An August 2022 paper (1) compared the effectiveness of exercise versus arthroscopic partial meniscectomy and further against an exercise for degenerative meniscal tears program in knee function at 5-year follow-up. The researchers of this study compiled data from four previously published studies. The data revealed that there was no significant differences in activities of daily living and quality of life in the study groups. The study concluded: “Moderate certainty of evidence suggests that the addition of arthroscopic partial meniscectomy to an exercise program adds no benefits in knee function at 5-year follow-up.”
A July 2022 study (2) also found “no evidence in support of arthroscopic partial meniscectomy in adults with degenerative and nonobstructive meniscal symptoms.” The researchers of this study tackled the problem of understanding the benefits of arthroscopic partial meniscectomy versus exercise. They write: “It is unclear whether the results of arthroscopic partial meniscectomy (APM) are comparable to a structured physical therapy (PT).”
In a review of data from 17 studies (2037 patients). the researchers found that current evidence suggests no difference in functional and clinical patient reported outcomes, pain, quality of life, physical performance measures, and osteoarthritis progression between the arthroscopic partial meniscectomy and structured physical therapy groups.
A July 2022 study (3) compared arthroscopic partial meniscectomy or exercise therapy outcomes in meniscus tear patients five years after treatments. The researchers found that exercise-based physical therapy worked as well as arthroscopic partial meniscectomy for patient-reported knee function. The authors recommended: “Physical therapy should therefore be the preferred treatment over surgery for degenerative meniscal tears. These results can assist in the development and updating of current guideline recommendations about treatment for patients with a degenerative meniscal tear.”
A November 2023 study (4) assessed patient outcomes in comparing arthroscopic partial meniscectomy versus physical therapy for traumatic meniscal tears in younger patients (under 45 years old).
One hundred patients, who suffered from a new traumatic isolated meniscal tear injury were split into two groups. One group (49 patients) had arthroscopic partial meniscectomy, the second group (51 patients) had physical therapy. Patients in the physical therapy group were given the option that they could move onto surgery at three months following the start of the study. Of which 21 patients (41%) had an arthroscopic partial meniscectomy within three months.
What the researchers recorded was that after 24 months and follow up of these patients, patients in the arthroscopic partial meniscectomy group had a lower quality of life and incurred more health costs (needed more health services. The researchers concluded that arthroscopic partial meniscectomy is not a better option than physical therapy in treating younger patients with isolated traumatic meniscal tears.
A November 2023 study (5) found that the older the patient, the time it takes to return to their sport or activity following arthroscopic meniscectomy increases. Additionally, athletes involved in non-contact sports and those having recreational sports activity levels experience greater delays in their return to sports as compared to athletes involved in combat and contact sports and athletes having elite and competitive sports levels.
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References
1 Fernández-Matías R, García-Pérez F, Gavín-González C, Martínez-Martín J, Valencia-García H, Flórez-García MT. Effectiveness of exercise versus arthroscopic partial meniscectomy plus exercise in the management of degenerative meniscal tears at 5-year follow-up: a systematic review and meta-analysis. Archives of Orthopaedic and Trauma Surgery. 2022 Aug 22.
2 Migliorini, F., Oliva, F., Eschweiler, J., Cuozzo, F., Hildebrand, F. and Maffulli, N., 2022. No evidence in support of arthroscopic partial meniscectomy in adults with degenerative and nonobstructive meniscal symptoms: a level I evidence-based systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, pp.1-11.
3 Noorduyn JC, van de Graaf VA, Willigenburg NW, Scholten-Peeters GG, Kret EJ, van Dijk RA, Buchbinder R, Hawker GA, Coppieters MW, Poolman RW, ESCAPE Research Group. Effect of physical therapy vs arthroscopic partial meniscectomy in people with degenerative meniscal tears: Five-year follow-up of the ESCAPE randomized clinical Trial. JAMA network open. 2022 Jul 1;5(7):e2220394-.
4 van der Graaff SJA, Reijman M, Meuffels DE, Koopmanschap MA; STARR Study Group; STARR Study Group; Eijgenraam SM, van Es EM, Hofstee DJ, Auw Yang KG, Noorduyn JCA, van Arkel ERA, van den Brand ICJB, Janssen RPA, Liu WY, Bierma-Zeinstra SMA. Cost-effectiveness of arthroscopic partial meniscectomy versus physical therapy for traumatic meniscal tears in patients aged under 45 years. Bone Joint J. 2023 Nov 1;105-B(11):1177-1183.
5 Yadav A, Kushwaha S, Kamal R, Khan FA, Sood A. Predictive Factors Influencing the Return to Sports Following Arthroscopic Knee Meniscectomy in Sports Persons: A Prospective Cohort Study. Cureus. 2023 Nov;15(11).