METEOR
Trial question
What is the role of surgery in symptomatic patients with a meniscal tear and knee osteoarthritis?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
57.0% female
43.0% male
N = 330
330 patients (187 female, 143 male).
Inclusion criteria: symptomatic patients ≥ 45 years of age with a meniscal tear and evidence of mild-to-moderate osteoarthritis on imaging.
Key exclusion criteria: chronically locked knee, inflammatory arthritis or clinically symptomatic chondrocalcinosis, injection with viscosupplementation, contraindication to surgery or physical therapy, bilateral symptomatic meniscal tear, or prior surgery on index knee.
Interventions
N=161 surgical meniscectomy (arthroscopic partial meniscectomy and postoperative physical therapy).
N=169 physical therapy alone (standardized physical-therapy regimen).
Primary outcome
Mean improvement in WOMAC score at 6 months
20.9 points
18.5 points
20.9 points
15.7 points
10.4 points
5.2 points
0.0 points
Surgical
meniscectomy
Physical therapy
alone
No significant
difference ↔
No significant difference in mean improvement in the WOMAC score at 6 months (20.9 points vs. 18.5 points; MD 2.4, 95% CI -1.8 to 6.5).
Secondary outcomes
No significant difference in mean improvement in the KOOS pain score after 6 months (24.2 vs. 21.3; MD 2.9, 95% CI -1.2 to 7).
No significant difference in mean improvement in the SF-36 physical-activity score after 6 months (24.2 vs. 23.1; MD 1.1, 95% CI -4.4 to 6.6).
Safety outcomes
No significant difference in adverse events.
Conclusion
In symptomatic patients ≥ 45 years of age with a meniscal tear and evidence of mild-to-moderate osteoarthritis on imaging, surgical meniscectomy was not superior to physical therapy alone with respect to mean improvement in the WOMAC score at 6 months.
Reference
Katz JN, Brophy RH, Chaisson CE et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013 May 2;368(18):1675-84.
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