Notas del episodio
In this episode of Ortho Appraised, Dr Rajabifard appraises "Arthroscopic meniscal surgery vs non-operative treatment for degenerative tears with mechanical symptoms: 5-year outcomes" published in the Journal of Orthopaedic Reports. The clinical question: for a degenerative meniscal tear with mechanical symptoms, does arthroscopic surgery beat non-operative care at five years? The evidence reinforces a non-operative-first approach.
📄 Citation: Zilani N, Tan J, Raj S, Maris A, Vasiliadis AV, Patel A. Arthroscopic meniscal surgery vs non-operative treatment for degenerative tears with mechanical symptoms: 5-year outcomes systematic review and meta-analysis of RCTs. J Orthop Rep. 2025;100809. DOI: https://doi.org/10.1016/j.jorep.2025.100809
Key Takeaways:
* Systematic review and meta-analysis of 6 RCTs (n=1,157) reporting 5-year outcomes — a Level I evidence synthesis.
* No clinically meaningful patient-reported outcome benefit from arthroscopic meniscal surgery over physiotherapy-led care.
* Even the "mechanical symptoms" subgroup — the usual justification for operating — showed no durable advantage.
* Risk of osteoarthritis was roughly doubled after surgery (OR 2.09, 95% CI 1.49–2.93).
* Practice implication: structured exercise-based care is a sound first line, interpreting the pooled estimates alongside the usual between-trial heterogeneity.
🔗 Full paper: https://doi.org/10.1016/j.jorep.2025.100809
Keywords: degenerative meniscal tear, knee arthroscopy, mechanical symptoms, meniscectomy versus physiotherapy, evidence-based knee surgery.
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