Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: A secondary analysis of a randomized trial. Sihvonen, R., Englund, M., Turkiewicz, A., & Jarvinen, T. L. N. Annals of internal medicine, 164(7):449–455, April, 2016. Paper doi abstract bibtex BACKGROUND: Recent evidence shows that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment of patients with a degenerative meniscus tear. However, patients who report mechanical symptoms (sensations of knee catching or locking) may benefit from APM. OBJECTIVE: To assess whether APM improves mechanical symptoms better than sham surgery. DESIGN: Randomized, patient- and outcome assessor-blinded, sham surgery-controlled, multicenter trial. (ClinicalTrials.gov: NCT00549172). SETTING: 5 orthopedic clinics in Finland. PATIENTS: Adults (aged 35 to 65 years) with a degenerative medial meniscus tear and no knee osteoarthritis. INTERVENTION: APM or sham surgery. MEASUREMENTS: Patients' self-report of mechanical symptoms before surgery and at 2, 6, and 12 months after surgery. RESULTS: 70 patients were randomly assigned to APM, and 76 were assigned to sham surgery. Thirty-two patients (46%) in the APM group and 37 (49%) in the sham surgery group reported catching or locking before surgery; the corresponding numbers at any follow-up were 34 (49%) and 33 (43%), with a risk difference of 0.03 (95% CI, -0.06 to 0.12). In the subgroup of 69 patients with preoperative catching or locking, the risk difference was 0.07 (CI, -0.08 to 0.22). LIMITATION: Analyses were post hoc, and the results are only generalizable to knee catching and occasional locking because few patients reported other types of mechanical symptoms. CONCLUSION: Resection of a torn meniscus has no added benefit over sham surgery to relieve knee catching or occasional locking. These findings question whether mechanical symptoms are caused by a degenerative meniscus tear and prompt caution in using patients' self-report of these symptoms as an indication for APM. PRIMARY FUNDING SOURCE: Academy of Finland.
@article{sihvonen_mechanical_2016-1,
title = {Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: {A} secondary analysis of a randomized trial.},
volume = {164},
issn = {1539-3704 0003-4819},
url = {http://dx.doi.org/10.7326%2FM15-0899},
doi = {10.7326/M15-0899},
abstract = {BACKGROUND: Recent evidence shows that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment of patients with a degenerative meniscus tear. However, patients who report mechanical symptoms (sensations of knee catching or locking) may benefit from APM. OBJECTIVE: To assess whether APM improves mechanical symptoms better than sham surgery. DESIGN: Randomized, patient- and outcome assessor-blinded, sham surgery-controlled, multicenter trial. (ClinicalTrials.gov: NCT00549172). SETTING: 5 orthopedic clinics in Finland. PATIENTS: Adults (aged 35 to 65 years) with a degenerative medial meniscus tear and no knee osteoarthritis. INTERVENTION: APM or sham surgery. MEASUREMENTS: Patients' self-report of mechanical symptoms before surgery and at 2, 6, and 12 months after surgery. RESULTS: 70 patients were randomly assigned to APM, and 76 were assigned to sham surgery. Thirty-two patients (46\%) in the APM group and 37 (49\%) in the sham surgery group reported catching or locking before surgery; the corresponding numbers at any follow-up were 34 (49\%) and 33 (43\%), with a risk difference of 0.03 (95\% CI, -0.06 to 0.12). In the subgroup of 69 patients with preoperative catching or locking, the risk difference was 0.07 (CI, -0.08 to 0.22). LIMITATION: Analyses were post hoc, and the results are only generalizable to knee catching and occasional locking because few patients reported other types of mechanical symptoms. CONCLUSION: Resection of a torn meniscus has no added benefit over sham surgery to relieve knee catching or occasional locking. These findings question whether mechanical symptoms are caused by a degenerative meniscus tear and prompt caution in using patients' self-report of these symptoms as an indication for APM. PRIMARY FUNDING SOURCE: Academy of Finland.},
language = {eng},
number = {7},
journal = {Annals of internal medicine},
author = {Sihvonen, Raine and Englund, Martin and Turkiewicz, Aleksandra and Jarvinen, Teppo L. N.},
month = apr,
year = {2016},
pmid = {26856620},
keywords = {Adult, Aged, Arthroscopy/*methods, Double-Blind Method, Female, Humans, Male, Menisci, Tibial/*injuries/physiopathology/*surgery, Middle Aged, Treatment Outcome},
pages = {449--455},
}
Downloads: 0
{"_id":"RRiqy8NpmPdWoPxHx","bibbaseid":"sihvonen-englund-turkiewicz-jarvinen-mechanicalsymptomsandarthroscopicpartialmeniscectomyinpatientswithdegenerativemeniscustearasecondaryanalysisofarandomizedtrial-2016","downloads":0,"creationDate":"2017-04-03T07:01:17.108Z","title":"Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: A secondary analysis of a randomized trial.","author_short":["Sihvonen, R.","Englund, M.","Turkiewicz, A.","Jarvinen, T. L. N."],"year":2016,"bibtype":"article","biburl":"https://api.zotero.org/groups/2575433/items?key=DE7AwkgUPeLruRBgvUzdo0Xc&format=bibtex&limit=100","bibdata":{"bibtype":"article","type":"article","title":"Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: A secondary analysis of a randomized trial.","volume":"164","issn":"1539-3704 0003-4819","url":"http://dx.doi.org/10.7326%2FM15-0899","doi":"10.7326/M15-0899","abstract":"BACKGROUND: Recent evidence shows that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment of patients with a degenerative meniscus tear. However, patients who report mechanical symptoms (sensations of knee catching or locking) may benefit from APM. OBJECTIVE: To assess whether APM improves mechanical symptoms better than sham surgery. DESIGN: Randomized, patient- and outcome assessor-blinded, sham surgery-controlled, multicenter trial. (ClinicalTrials.gov: NCT00549172). SETTING: 5 orthopedic clinics in Finland. PATIENTS: Adults (aged 35 to 65 years) with a degenerative medial meniscus tear and no knee osteoarthritis. INTERVENTION: APM or sham surgery. MEASUREMENTS: Patients' self-report of mechanical symptoms before surgery and at 2, 6, and 12 months after surgery. RESULTS: 70 patients were randomly assigned to APM, and 76 were assigned to sham surgery. Thirty-two patients (46%) in the APM group and 37 (49%) in the sham surgery group reported catching or locking before surgery; the corresponding numbers at any follow-up were 34 (49%) and 33 (43%), with a risk difference of 0.03 (95% CI, -0.06 to 0.12). In the subgroup of 69 patients with preoperative catching or locking, the risk difference was 0.07 (CI, -0.08 to 0.22). LIMITATION: Analyses were post hoc, and the results are only generalizable to knee catching and occasional locking because few patients reported other types of mechanical symptoms. CONCLUSION: Resection of a torn meniscus has no added benefit over sham surgery to relieve knee catching or occasional locking. These findings question whether mechanical symptoms are caused by a degenerative meniscus tear and prompt caution in using patients' self-report of these symptoms as an indication for APM. PRIMARY FUNDING SOURCE: Academy of Finland.","language":"eng","number":"7","journal":"Annals of internal medicine","author":[{"propositions":[],"lastnames":["Sihvonen"],"firstnames":["Raine"],"suffixes":[]},{"propositions":[],"lastnames":["Englund"],"firstnames":["Martin"],"suffixes":[]},{"propositions":[],"lastnames":["Turkiewicz"],"firstnames":["Aleksandra"],"suffixes":[]},{"propositions":[],"lastnames":["Jarvinen"],"firstnames":["Teppo","L.","N."],"suffixes":[]}],"month":"April","year":"2016","pmid":"26856620","keywords":"Adult, Aged, Arthroscopy/*methods, Double-Blind Method, Female, Humans, Male, Menisci, Tibial/*injuries/physiopathology/*surgery, Middle Aged, Treatment Outcome","pages":"449–455","bibtex":"@article{sihvonen_mechanical_2016-1,\n\ttitle = {Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: {A} secondary analysis of a randomized trial.},\n\tvolume = {164},\n\tissn = {1539-3704 0003-4819},\n\turl = {http://dx.doi.org/10.7326%2FM15-0899},\n\tdoi = {10.7326/M15-0899},\n\tabstract = {BACKGROUND: Recent evidence shows that arthroscopic partial meniscectomy (APM) offers no benefit over conservative treatment of patients with a degenerative meniscus tear. However, patients who report mechanical symptoms (sensations of knee catching or locking) may benefit from APM. OBJECTIVE: To assess whether APM improves mechanical symptoms better than sham surgery. DESIGN: Randomized, patient- and outcome assessor-blinded, sham surgery-controlled, multicenter trial. (ClinicalTrials.gov: NCT00549172). SETTING: 5 orthopedic clinics in Finland. PATIENTS: Adults (aged 35 to 65 years) with a degenerative medial meniscus tear and no knee osteoarthritis. INTERVENTION: APM or sham surgery. MEASUREMENTS: Patients' self-report of mechanical symptoms before surgery and at 2, 6, and 12 months after surgery. RESULTS: 70 patients were randomly assigned to APM, and 76 were assigned to sham surgery. Thirty-two patients (46\\%) in the APM group and 37 (49\\%) in the sham surgery group reported catching or locking before surgery; the corresponding numbers at any follow-up were 34 (49\\%) and 33 (43\\%), with a risk difference of 0.03 (95\\% CI, -0.06 to 0.12). In the subgroup of 69 patients with preoperative catching or locking, the risk difference was 0.07 (CI, -0.08 to 0.22). LIMITATION: Analyses were post hoc, and the results are only generalizable to knee catching and occasional locking because few patients reported other types of mechanical symptoms. CONCLUSION: Resection of a torn meniscus has no added benefit over sham surgery to relieve knee catching or occasional locking. These findings question whether mechanical symptoms are caused by a degenerative meniscus tear and prompt caution in using patients' self-report of these symptoms as an indication for APM. PRIMARY FUNDING SOURCE: Academy of Finland.},\n\tlanguage = {eng},\n\tnumber = {7},\n\tjournal = {Annals of internal medicine},\n\tauthor = {Sihvonen, Raine and Englund, Martin and Turkiewicz, Aleksandra and Jarvinen, Teppo L. N.},\n\tmonth = apr,\n\tyear = {2016},\n\tpmid = {26856620},\n\tkeywords = {Adult, Aged, Arthroscopy/*methods, Double-Blind Method, Female, Humans, Male, Menisci, Tibial/*injuries/physiopathology/*surgery, Middle Aged, Treatment Outcome},\n\tpages = {449--455},\n}\n\n","author_short":["Sihvonen, R.","Englund, M.","Turkiewicz, A.","Jarvinen, T. L. N."],"key":"sihvonen_mechanical_2016-1","id":"sihvonen_mechanical_2016-1","bibbaseid":"sihvonen-englund-turkiewicz-jarvinen-mechanicalsymptomsandarthroscopicpartialmeniscectomyinpatientswithdegenerativemeniscustearasecondaryanalysisofarandomizedtrial-2016","role":"author","urls":{"Paper":"http://dx.doi.org/10.7326%2FM15-0899"},"keyword":["Adult","Aged","Arthroscopy/*methods","Double-Blind Method","Female","Humans","Male","Menisci","Tibial/*injuries/physiopathology/*surgery","Middle Aged","Treatment Outcome"],"metadata":{"authorlinks":{"englund, m":"https://www.clinicalepidemiology.se/LatestPubs/"}}},"search_terms":["mechanical","symptoms","arthroscopic","partial","meniscectomy","patients","degenerative","meniscus","tear","secondary","analysis","randomized","trial","sihvonen","englund","turkiewicz","jarvinen"],"keywords":["adult","aged","arthroscopy/*methods","double-blind method","female","humans","male","menisci","tibial/*injuries/physiopathology/*surgery","middle aged","treatment outcome"],"authorIDs":["FGEw4uqPTihigKZcf"],"dataSources":["QDub7pfxdk2ms2NxS","5jEuhQhgRx3py8LmG"]}