Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effect of Arthroscopic Partial Meniscectomy or Exercise Therapy as Treatment of Degenerative Meniscus Tears in Middle-aged Patients. A Randomized, Controlled Trial
Brief Summary: This study is conducted as a collaboration between NAR, Orthopedic Department, Oslo University Hospital,Ullevaal, Hjelp24Nimi Oslo, Martina Hansens Hospital Norway, and University of Southern Denmark, Odense, Denmark.

The investigators hypothesize that exercise is more effective than arthroscopic partial meniscectomy: a) on self-reported outcomes, functional performance and muscle strength in middle-aged patients subsequent to arthroscopic partial meniscectomy for a degenerative meniscus tear, and b) in preventing further development of knee osteoarthritis (OA).


Options:
A: Inclusion Criteria:

* All (consecutive) patients referred to the orthopaedic department in Linköping for a suspected meniscal injury
* Age:45-64 years old
* No gonarthrosis (Ahlbäck=0) on standing radiographs

Exclusion Criteria:

* Rheumatic disease
* Patellofemoral arthrosis
* Fibromyalgia
* A knee or hip replacement
* A neurologic disorder including stroke
* A contraindication for an operation
* Catching or locking for more than 2 seconds more than once a week
* A permanent extension deficit
* Patients who cannot understand instructions in Swedish
B: Inclusion Criteria:

1. Age: 35 to 65 years of age.
2. A pain located on the medial joint line of the knee that has persistent at least for 3 months.
3. Pain that can be provoked by palpation or compression of the joint line or a positive McMurray sign.
4. Tear of the medial meniscus on MRI.
5. Degenerative rupture of the medial meniscus confirmed at arthroscopy.

Exclusion Criteria:

1. Acute, trauma-induced onset of symptoms.
2. Locking or painful snapping of the knee joint.
3. A surgical operation performed on the affected knee.
4. Osteoarthritis of the medial compartment of the knee (determined by clinical criteria of the ACR).
5. Osteoarthritis on knee radiographs (Kellgren-Lawrence \> 1).
6. Acute (within the previous year) fractures of the knee.
7. Decreased range of motion of the knee.
8. Instability of the knee.
9. MRI assessment showing a tumor or any other complaint requiring surgical or other means of treatment.
10. Arthroscopic assessment showing anything other than a degenerative tear of the medial meniscus requiring surgical intervention.
C: Inclusion Criteria:

* Age 35-60 years
* Knee pain for more than 2 months without a significant trauma
* Medial meniscal tear on MRI
* Eligible for arthroscopic partial meniscectomy
* Grade 0-2 radiographic severity (specification after Kellgren Lawrence)

Exclusion Criteria:

* Those requiring acute trauma surgeries, including those treated as acute cases in the ER
* Ligament injuries
* Tumours (MRI)
* Pain or other musculoskeletal comorbidities severely affecting lower extremity muscle function overriding the symptoms from the knee
* Grade 3 or 4 radiographic severity (specification after Kellgren Lawrence)
* Comorbidities excluding physical activities and exercise.
* Previous knee surgery within two years
* Not able to speak or read Norwegian, drug abuse or mental problems
D: Inclusion Criteria:

* Adults aged 18 to 40 years with knee pain
* Clinical history and symptoms consistent with meniscal tear and meniscal tear verified on magnetic resonance imaging (MRI)
* Deemed eligible for meniscal surgery (i.e. repair or resection) by the examining orthopedic surgeon
* Willing to participate in 12 weeks of supervised exercise twice a week or undergo surgery for the meniscal tear as soon as possible

Exclusion Criteria:

* Previous knee surgery on the affected knee
* Clinical suspicion (acute locking of knee AND/OR extension deficit) of displaced bucket-handle tear confirmed by MRI
* Fracture of the affected extremity within the previous 12 months
* Complete rupture of one or more knee ligaments.
* Participation in supervised systematic exercise for knee problems within the last 3 months prior to recruitment
* Other reasons for exclusion (Unable to understand Danish, mentally unable to participate, etc.)

Answer: C