Early surgery or exercise and education for meniscal tears in young adults

Review written by Dr Teddy Willsey info

Key Points

  1. Most of the research to date on conservative management for meniscus tears has been focused on older adults and degenerative pathology.
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BACKGROUND & OBJECTIVE

Arthroscopic meniscus surgeries doubled in the U.S. from 2005 to 2011 (1). Over 2 million arthroscopic knee procedures are performed worldwide each year (2). Recent investigations indicate that arthroscopic partial meniscectomy provides no benefit over sham surgery, yet meniscal arthroscopy continues to be a common surgical procedure (3,4). Exercise therapy has been shown to be a viable standalone treatment option for a variety of knee conditions across all age groups, including meniscal lesions in older adults (5,6).

Despite the efficacy of conservative management in older populations, surgical repair remains the preferred treatment method for meniscus lesions in younger adults (7). The surgery-first approach for meniscus pathology in younger adults has yet to be researched.

The purpose of this study was to compare supervised exercise therapy and education with an option for later surgery, versus early arthroscopic repair for meniscal lesions in younger adults.

Over 2 million arthroscopic knee procedures are performed worldwide each year.
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Young adults presenting with symptomatic meniscus pathology that is not severe should be encouraged to pursue conservative rehabilitation prior to considering surgery.

METHODS

121 adults aged 18 to 40 (mean age = 30) with symptomatic meniscal tears confirmed via MRI, were recruited to the pragmatic design randomized controlled trial. 28% of participants were female, 74% reported a moderate to high activity level, and

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