Long-term consequences of degenerative meniscal tears in middle-aged patients
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Abstract
Degenerative meniscal tears represent an early sign of knee osteoarthritis. Arthroscopic partial menis-cectomy has been the usual treatment for symptomatic tears, but studies have shown no additional benefit compared to exercise therapy up to two years following treatment. In this thesis, “Long-term consequences of degenerative meniscal tears in middle-aged patients”, ar-throscopic partial meniscectomy was compared to exercise therapy in a five-year follow-up of a ran-domized controlled trial including 140 patients. No between-group differences in progression of radiographic knee osteoarthritis changes were found over five years. Both treatment groups had clinically relevant improvements in patient-reported pain and knee function, but neither treatment was superior. Exercise therapy effectively improved knee muscle strength up to 12 months compared to arthroscopic partial meniscectomy. Quadriceps muscle weakness at study inclusion was a risk factor for knee osteoarthritis progression over five years. The results of this thesis support the ongoing change in treatment strategy for degenerative meniscal tears, recommending exercise therapy over surgery as the first-line treatment.List of papers
Paper I. Berg B, Roos EM, Englund M, Kise NJ, Tiulpin A, Saarakkala S, Engebretsen L, Eftang CN, Holm I, Risberg MA. Development of osteoarthritis in patients with degenerative meniscal tears treated with exercise therapy or surgery: a randomized controlled trial. Osteoarthritis Cartilage. 2020;28(7):897-906. doi: 10.1016/j.joca.2020.01.020. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1016/j.joca.2020.01.020 |
Paper II. Berg B, Roos EM, Kise NJ, Engebretsen L, Holm I, Risberg MA. On a Trajectory for Success—9 in Every 10 People With a Degenerative Meniscus Tear Have Improved Knee Function Within 2 Years After Treatment: A Secondary Exploratory Analysis of a Randomized Controlled Trial. J Orthop Sports Phys Ther. 2021;51(6):289-297. doi: 10.2519/jospt.2021.10025. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.2519/jospt.2021.10025 |
Paper III. Berg B, Roos EM, Kise NJ, Engebretsen L, Holm I, Risberg MA. Muscle strength and osteoarthritis progression after surgery or exercise for degenerative meniscal tears: Secondary analyses of a randomized trial (Manus). Published in: Arthritis Care Res, 2022, 74: 70-78. DOI: 10.1002/acr.24736. The paper is included in the thesis. Also available at: https://doi.org/10.1002/acr.24736 |