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.
Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: A secondary analysis of a randomized trial. [link]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},
}

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