Please select the eligibility criteria that correspond to the clinical trial below.
Title: Is a Knee Arthroscopy of Any Benefit for the Middleaged Patient With Meniscal Symptoms?
Brief Summary: The purpose of this study is to determine whether a knee arthroscopy is effective in the treatment of middleaged patients with meniscal symptoms also receiving a standardised exercise program.


Options:
A: Inclusion Criteria:

* Single symptomatic lesion of the trochlea, medial or lateral femoral condyle of the knee less than 2 cm2
* Cartilage lesion ICRS grade 3 or 4
* More than 50 % of the menisci intact
* Ligamentous stable knee
* Lysholm Score \< 75
* Acceptable range of motion (5-105 degrees)

Exclusion Criteria:

* Osteoarthritis
* Malalignment \> 5 degrees measured clinically, and if uncertainty on HKA radiographs
* Systemic arthritis
* Previous cartilage surgery except OCD fixation
* Obesity BMI \> 30
* Serious drig or alcohol abuse
* Inability to answer questionnaires or partake in rehabilitation
* Comorbidity that may influence surgery or rehabilitation
* Pregnancy
B: Inclusion Criteria:

1. Idiopathic or secondary osteoarthritis of the knee as diagnosed by Altman et al 2 classification tree -83 percent sensitivity, 93percent specificity
2. Grades 2 to 4 severity of OA by radiographic evaluation- modified Kellgren and Lawrence grading system
3. Age greater than 18.

Exclusion Criteria:

1. Inflammatory or post-infection arthritis of the knee
2. Previous arthroscopy for treatment of knee OA
3. Isolated medial compartment OA Grade 3-4 with greater than 5 degrees mechanical varus -ideal candidate for high tibial osteotomy
4. Isolated lateral compartment OA Grade III-IV with greater than 5 degrees mechanical valgus -ideal candidate for high tibial osteotomy or distal femoral osteotomy
5. Grade 4 OA in at least 2 compartments and over 60 years of age -ideal candidate for total knee arthroplasty
6. Cortico-steroid injection within the last three months.
7. Major neurological deficit
8. Major medical illness -life expectancy less than 2 years or with unacceptably high operative risk.
9. Pregnant
10. Unable to speak or read English
11. Psychiatric illness that limits informed consent
12. Unwilling to be followed for 2 years
C: 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
D: Inclusion Criteria:

* OA symptoms lasting at least 1 month and managed with medications, activity limitations, and/or physical therapy
* At least one symptom consistent with a torn meniscus. Symptoms may include clicking, catching, popping, giving way, pain with pivot or torque, episodic pain, and/or pain that is acute and localized to one joint line.
* Available knee X-ray (within 6 months) and MRI (within 3 years)
* Evidence of osteophyte formation or cartilage fissure, tear, or loss on a knee MRI OR plain radiographic evidence of osteophyte formation or joint space narrowing
* Evidence of a meniscal tear (tear extending to surface of meniscus) on a knee MRI
* Willingness to undergo random assignment and sign an informed consent

Exclusion Criteria:

* Chronically locked knee
* Kellgren-Lawrence Grade IV status, indicating advanced OA and usually the need for total knee replacement
* Contraindication to MRI
* Radiographic chondrocalcinosis (a condition in which there are deposits of calcium pyrophosphate dihydrate \[CPPD\] crystals in one or more joints that eventually result in damage to the affected joints) AND acute symptomatic pseudogout
* Inflammatory diseases (e.g., rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, gout, pseudogout)
* Injection with viscosupplementation in the affected knee in the 4 weeks before study entry
* Any medical contraindications to surgery or physical therapy
* Both knees are symptomatic for meniscal tears and a candidate for bilateral APMs
* Prior surgery on an affected knee
* Pregnancy or possible pregnancy
* Claim filed for worker's compensation
* Unable or unwilling to give informed consent
* Unable or unwilling to attend physical therapy sessions at designated locations or in the community

Answer: C