Can baseline MRI findings identify who responds better to early surgery versus exercise and education in young patients with meniscal tears? A subgroup analysis from the DREAM trial

Review written by Todd Hargrove info

Key Points

  1. Knee effusion/synovitis on MRI was associated with better outcomes from early surgery compared to exercise therapy for young patients with meniscal tears.
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BACKGROUND & OBJECTIVE

Arthroscopic surgery on the meniscus is one of the most common orthopedic procedures, but recent randomized controlled trials have shown that early surgery is not superior to exercise therapy for meniscal tears in young adults. However, it is possible that specific subgroups of patients might benefit more from surgery than exercise.

This study aimed to investigate whether baseline MRI findings could identify subgroups of young patients with meniscal tears who would respond better to early surgery versus exercise therapy.

Arthroscopic surgery on the meniscus is one of the most common orthopedic procedures.
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Patients with knee effusion/synovitis on MRI showed greater improvement with surgery and the type and location of meniscal tear did not influence treatment outcomes, however, these findings should be interpreted cautiously.

METHODS

The researchers conducted a secondary analysis of data from the Danish RCT on Exercise versus Arthroscopic Meniscal surgery for young adults (DREAM) trial, which included 121 patients aged 18-40 years with MRI-confirmed meniscal tears.

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