Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear
Arthroscopic partial meniscectomy is one of the most common orthopeadic procedures, yet rigorous evidence of its efficacy is lacking. In this heavily promoted paper, a multicentre, randomised, double-blind, sham-controlled trial in 146 patients, 35 to 65 years of age who had knee symptoms consistent with a degenerative medial meniscus tear and no knee osteoarthritis were randomly assigned to arthroscopic partial meniscectomy or sham surgery.
In the intention-to-treat analysis, there were no significant between-group differences in the change from baseline to 12 months in any primary outcome. There were no significant differences between groups in the number of patients who required subsequent surgery. In this trial, the outcomes after arthroscopic partial meniscectomy were no better than those after a sham surgical procedure.
Despite strong trial procedures, the study rationale and inclusion/exclusion criteria limit the results of this study, and in turn has not added to the body of knowledge greatly despite large media and professional attention. > From: Sihvonen et al., N Engl J of Med 369 (2013) 2515-2524. All rights reserved to the New England Journal of Medicine. Image taken from: londonkneeclinic.com.
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