Is a Knee Arthroscopy of Any Benefit for the Middleaged Patient With Meniscal Symptoms?

Study Overview
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Brief Summary
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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.

Detailed Description
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There are no studies proving a significant positive effect of a knee arthroscopy in middleaged patients with meniscal symptoms in excess of a structured rehabilitation program. In this study consecutive patients aged 45-64 years referred to the orthopaedic department at the University hospital Linköping for a suspected meniscal injury will be randomised to a rehabilitation program or a knee arthroscopy + the same rehabilitation program. Functional tests will be performed by a physiotherapist. There will be patient administrated questionaries sent out after 3 and 12 month.

Official Title
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Is a Knee Arthroscopy of Any Benefit for the Middleaged Patient With Meniscal Symptoms?

Conditions
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Chronic Meniscus Injury

Intervention / Treatment
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* Procedure: Knee arthroscopy


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 64 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Arthroscopy<br>Knee arthroscopy + Exercise therapy | Procedure: Knee arthroscopy<br>* Knee arthroscopy within 4 weeks.<br>|
| No Intervention: Exercise therapy<br>Exercise therapy alone | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| KOOS (Knee injury and Osteoarthritis Outcome Score); Pain subscale | KOOS is a 42 item selfadministrated questionnaire with 5 separate subscales; pain, symptoms, activities of daily living (ADL), sport and recreation, quality of life (QoL). A change of approximately 10 is considered a clinical important difference (CID). At 12 month after the randomization the arthroscopy+exercise therapy arm will be compared to the exercise therapy alone arm. | 12 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| KOOS (Knee injury and Osteoarthritis Outcome Score) |  | 3 month | 
| Tegner activity scale |  | 12 month | 
| KOOS (Symptoms, ADL, Sport/rec, QOL subscores) |  | 12 month | 
| Functional tests | Squatting (possible without pain, possible with pain, not possible). SOLEC ( one-legged stance) barefoot. Best time for three trials. Standing up from a chair on one leg, maximum repetitions in 30 sec. All test supervised by a physiotherapist. | 3 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Meniscal injury, Knee arthroscopy, Middleaged, Functional outcome