Effect of Exercise Therapy Compared with Arthroscopic Surgery on Knee Muscle Strength and Functional Performance in Middle-Aged Patients with Degenerative Meniscus Tears: A 3-Mo Follow-up of a Randomized Controlled Trial. (June 2015)

• Record Type: Journal Article
• Authors: Stensrud, Silje; Risberg, May Arna; Roos, Ewa M.
• Is Part Of: American journal of physical medicine & rehabilitation. Volume 94:Number 6(2015)
• Publication Date: 2015-06
• Subjects: Degenerative Meniscus -- Exercise Therapy -- Arthroscopy -- Quadriceps -- Knee Osteoarthritis; Rehabilitation -- Periodicals; Medicine, Physical -- Periodicals; 617.062
• DOI: 10.1097/PHM.0000000000000209
• Languages: English
• ISSNs: 0894-9115

Abstract

ABSTRACT: Objective: The aim of this study was to compare the effect of a 12-wk exercise therapy program and arthroscopic partial meniscectomy on knee strength and functional performance in middle-aged patients with degenerative meniscus tears. Design: A total of 82 patients (mean age, 49 yrs; 35% women) with a symptomatic, unilateral, magnetic resonance imaging–verified degenerative meniscus tear and no or mild radiographic osteoarthritis were randomly assigned to a supervised neuromuscular and strength exercise program or arthroscopic partial meniscectomy. Outcomes assessed 3 mos after intervention initiation were isokinetic knee muscle strength, lower extremity performance, and self-reported global rating of change. Results: Mean difference in isokinetic knee extension peak torque between the two groups was 16% (95% confidence interval, 7.1–24.0) ( P < 0.0001), favoring the exercise group. Patients in the exercise group improved isokinetic knee extension peak by a mean of 25 Nm (range, 18–33 Nm) from baseline to follow-up. Furthermore, patients assigned to exercise therapy showed statistically significant improvements ( P ⩽ 0.002) in all other measured variables, with moderate to large effect sizes (0.5–1.3). Patients reported a similar and positive effect of both interventions. Conclusion: A 12-wk supervised exercise therapy program yielded clinically relevant and statistically significant improvement in isokinetic quadriceps strength immediately after completion of the program, as compared with treatment with arthroscopic partial meniscectomy.