Development of Knee Osteoarthritis After Arthroscopic Partial Resection of Degenerative Meniscus Tear

Conditions

Arthroscopy, Meniscal Tear, Osteoarthritis of the Knee

Keywords

Sham-surgery, Development of osteoarthritis, Randomized, double-blinded, placebo-controlled

Brief summary

It has been previously demonstrated that the risk for the development of knee osteoarthritis is increased after both meniscus tear and meniscectomy. However, it is still unclear whether this is due to the meniscus tear per se, the surgery, or whether the development of knee osteoarthritis is completely independent of the two. Accordingly, the aim of the study is to investigate the effect of arthroscopic partial meniscectomy on the development of knee osteoarthritis 2 to 10 years after the procedure.

Detailed description

It has been previously demonstrated that the risk for the development/progression of knee osteoarthritis is increased after both meniscus tear and meniscectomy. However, it is still unclear whether this is due to the meniscus tear per se (i.e., adverse mechanical effect on knee cartilage), the surgery (resection of the meniscus, and subsequent loss of cushion within the knee), or whether the development of knee osteoarthritis is completely independent of the two. Accordingly, the aim of the study is to investigate the effect of Arthroscopic partial meniscectomy on the development of knee osteoarthritis 2 to 10 years after the procedure. Patients included in the study will be randomized into one of two groups: arthroscopic partial meniscectomy and diagnostic arthroscopy (sham-surgery). The presence of knee osteoarthritis will be assessed preoperatively and 2, 5, and 10 years after the operation.

Niko Sillanpää, M Iivanainen, Aleksandra Turkiewicz, Raine Sihvonen, Mika Paavola et al. (8 authors)

Osteoarthritis and Cartilage2024-09-127 citations

10.1016/j.joca.2024.09.003

Arthroscopic partial meniscectomy for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial

Raine Sihvonen, Mika Paavola, Antti Malmivaara, Ari Itälä, Antti Joukainen et al. (15 authors)

British Journal of Sports Medicine2020-08-27123 citations

10.1136/bjsports-2020-102813

Statistical analysis plan for the 5-year and 10-year follow-up assessments of the FIDELITY trial.

Sihvonen R, Kalske R, Englund M, Turkiewicz A, Toivonen P, Taimela S, Järvinen TLN, Finnish Degenerative Meniscal Lesion Study (FIDELITY) Investigators.

2020-01-142 citations

10.1186/s13063-019-3833-2

Interventions

PROCEDUREArthroscopic partial meniscectomy

Arthroscopic partial meniscectomy of the degenerative tear of medial meniscus

PROCEDUREArthroscopy (diagnostic)

Diagnostic arthroscopy of the knee

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Masking

TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

35 Years to 65 Years

Healthy volunteers

No

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.

Design outcomes

Primary

Measure	Time frame
Radiological assessment of OA of the knee (Kellgren-Lawrence -classification)	2 and 10 years postoperatively

Secondary

Measure	Time frame
ACR (The American College of Rheumatology) clinical criteria for Osteoarthritis of the knee	2 and 10 years postoperatively

Countries

Finland

Outcome results

None listed