Knee Osteoarthritis Clinical Trial
Official title:
Randomised Controlled Trial Comparing Arthroscopy With Physiotherapy for Degenerative Meniscal Tears
Patients with wear and tear in their knees (osteoarthritis) are often referred to orthopaedic
surgeons following a sudden worsening of pain and mechanical symptoms (grinding, locking,
giving way) in their knee due to tears of their meniscal cartilages. These tears are
described as degenerative as they are not usually caused by a single injury but rather
accumulation of wear and tear. It is not clear from the current available evidence what the
best treatment for these patients is. Their underlying arthritis is not bad enough to require
joint replacement yet and they were usually managing well with minimal problems from their
knee until experiencing the meniscal tear. However, some of their symptoms are likely to be
due to the arthritis rather than just the tear. Current treatment for these patients is
usually in the form of conservative treatment with physiotherapy and supervised exercise or
using arthroscopy (key-hole surgery) to trim the damaged area of the meniscus. We know from
previous research that most of these patients will improve over time to some extent but it is
not clear whether a greater improvement can be expected following surgery and if so, whether
this applies to all patients with this problem or not.
Our study is intended to compare the outcome of patients with proven degenerative meniscal
tears imaged on MRI scans, when they are assigned to arthroscopy followed by supervised
exercise or supervised exercise alone. They will be randomly assigned and the outcome will be
assessed using patient-completed questionnaires (Knee Outcome Osteoarthritis and injury Score
[KOOS], SF12, visual analogue score for pain) and whether the patients go on to require
further surgery during the period of the trial. The patients will be assessed at baseline, at
6 weeks, 6 months, 12 months and 24 months.
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