Treatment of Meniscal Tear
Authors: Rachelle Buchbinder, Ian Harris
Journal: Annals of Internal Medicine (2016)

Letters18 October 2016Treatment of Meniscal TearRachelle Buchbinder, MBBS(Hons), MSc, PhD and Ian Harris, AM, MBBS, MMed(Clin Epi), PhDRachelle Buchbinder, MBBS(Hons), MSc, PhDFrom Monash Department of Clinical Epidemiology, Cabrini Institute and Monash University, Malvern, Victoria, Australia, and Whitlam Orthopaedic Research Centre and Ingham Institute for Applied Medical Research, UNSW, Liverpool, New South Wales, Australia.Search for more papers by this author and Ian Harris, AM, MBBS, MMed(Clin Epi), PhDFrom Monash Department of Clinical Epidemiology, Cabrini Institute and Monash University, Malvern, Victoria, Australia, and Whitlam Orthopaedic Research Centre and Ingham Institute for Applied Medical Research, UNSW, Liverpool, New South Wales, Australia.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0327 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We question some of Katz and Jones' (1) conclusions on Sihvonen and colleagues' placebo-controlled trial. The results of this trial do not support a role for arthroscopic partial meniscectomy (APM) in patients with symptomatic degenerative meniscal tears (2, 3). Katz and Jones state that, on the basis of the available evidence, physical therapy and APM both have a role in this clinical population. However, they neglect to note that the open, randomized trials that have compared APM with physical therapy probably overestimated any benefit of surgery because of bias inherent in unblinded trials, whereas no between-group differences ...References1. Katz JN, Jones MH. Treatment of meniscal tear: the more we learn, the less we know [Editorial]. Ann Intern Med. 2016;164:503-4. [PMID: 26856759]. doi:10.7326/M16-0049 LinkGoogle Scholar2. Sihvonen R, Englund M, Turkiewicz A, Järvinen TL; Finnish Degenerative Meniscal Lesion Study Group. Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: a secondary analysis of a randomized trial. Ann Intern Med. 2016;164:449-55. [PMID: 26856620]. doi:10.7326/M15-0899 LinkGoogle Scholar3. Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, et al; Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013;369:2515-24. [PMID: 24369076] doi:10.1056/NEJMoa1305189 CrossrefMedlineGoogle Scholar4. Yim JH, Seon JK, Song EK, Choi JI, Kim MC, Lee KB, et al. A comparative study of meniscectomy and nonoperative treatment for degenerative horizontal tears of the medial meniscus. Am J Sports Med. 2013;41:1565-70. [PMID: 23703915] doi:10.1177/0363546513488518 CrossrefMedlineGoogle Scholar5. Papalia R, Del Buono A, Osti L, Denaro V, Maffulli N. Meniscectomy as a risk factor for knee osteoarthritis: a systematic review. Br Med Bull. 2011;99:89-106. [PMID: 21247936] doi:10.1093/bmb/ldq043 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Monash Department of Clinical Epidemiology, Cabrini Institute and Monash University, Malvern, Victoria, Australia, and Whitlam Orthopaedic Research Centre and Ingham Institute for Applied Medical Research, UNSW, Liverpool, New South Wales, Australia.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L16-0327. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Meniscal Tear: The More We Learn, the Less We Know Jeffrey N. Katz and Morgan H. Jones Treatment of Meniscal Tear Jeffrey N. Katz and Morgan H. Jones Metrics 18 October 2016Volume 165, Issue 8Page: 602-603KeywordsConflicts of interestDisclosureExerciseExercise therapyRandomized trialsSurgery ePublished: 18 October 2016 Issue Published: 18 October 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...