Article Figures & Tables
Figures
- Figure 1:
Selection of randomized controlled trials (RCTs) for inclusion in the meta-analysis.
- Figure 2:
Risk-of-bias assessment of randomized controlled trials included in the meta-analysis.
- Figure 3:
Pooled short-term functional outcomes of conservative and surgical treatment. Red lines show a zone of clinical equivalence based on a minimal important difference of 10 on the Knee Injury and Osteoarthritis Outcome Score.37,39,40–43 Note: CI = confidence interval, SD = standard deviation, SMD = standardized mean difference.
- Figure 4:
Pooled long-term functional outcomes of conservative and surgical treatment. Red lines show a zone of clinical equivalence based on a minimal important difference of 10 on the Knee Injury and Osteoarthritis Outcome Score.38–41,43 Note: CI = confidence interval, SD = standard deviation, SMD = standardized mean difference.
Tables
Study Year Country Patient characteristics Treatment arm, no. of patients and description of treatment* Major outcome measures OA inclusion Loss to follow-up Mean age, yr Male sex, % Conservative Surgical Herrlin et al.37 2007 Sweden 55 61 43
Standardized exercise program for 8 wk47
Arthroscopic meniscal débridementKOOS, Lysholm Knee Scoring Scale, Tegner Activity Scale, VAS scores at 8 wk, 6 mo Ahlbäck criteria grade 0–1 NR Herrlin et al.38 2013 Sweden 55 60 49
Standardized exercise program for 8 wk47
Arthroscopic meniscal débridementLysholm Knee Scoring Scale, Tegner Activity Scale, VAS scores (at rest and with activity) at 24, 60 mo Ahlbäck criteria grade 0–1 C: 2/49
S: 2/47Katz et al.39 2013 United States 58 43 169
Land-based, individualized physical therapy with progressive home exercise161
Arthroscopic meniscal débridementWOMAC-pf, KOOS pain scale, SF-36 physical activity scores at 3, 6, 12 mo Kellgren–Lawrence grade 0–3 C: 2/169
S: 1/161Østerås et al.42 2012 Norway 50 76 9
Exercise program
3 times/wk for 3 mo8
Arthroscopic meniscal débridementKOOS, VAS, HAD scores, quadriceps muscle strength at 3 mo Kellgren–Lawrence grade 0–2 0 Sihvonen et al.40 2013 Finland 52 61 76
Sham surgical procedure70
Arthroscopic meniscal débridementLysholm Knee Scoring Scale, WOMET, VAS, 15D, patient satisfaction scores at 2, 6, 12 mo Kellgren–Lawrence grade 0–1 0 Yim et al.41 2013 South Korea 56 21 52
NSAIDs, 3 wk supervised physical exercise followed by 8 wk home exercise program50
Arthroscopic meniscal débridementLysholm Knee Scoring Scale, VAS, patient satisfaction, Tegner Activity Scale scores at 3, 6 mo, 1, 2 yr Kellgren–Lawrence grade 0–1 C: 2/54
S: 4/54Vermesan et al.43 2013 Romania 58 23 60 knees
Interarticular steroid injection60 knees
Arthroscopic meniscal débridementOxford Knee Score at 1 mo, 1 yr Kellgren–Lawrence grade 0–1 0 Note: 15D = a health-related quality-of-life scale made up of 15 dimensions on a scale of 0 (death) to 1 (full health), C = conservative treatment arm, HAD = Hospital Anxiety and Depression, KOOS = Knee Injury and Osteoarthritis Outcome Score, NR = not reported, NSAIDs = nonsteroidal anti-inflammatory drugs, OA = osteoarthritis, S = surgical treatment arm, SF-36 = Short Form 36, VAS = visual analogue scale, WOMAC-pf = Western Ontario and McMaster Universities Osteoarthritis Index — physical function, WOMET = Western Ontario Meniscal Evaluation Tool.
↵* Conservative to surgical crossover: Herrlin et al.,37 NR; Herrlin et al.,38 27%; Katz et al.,39 30%; Østerås et al.,42 0%; Sihvonen et al.,40 7%; Yim et al.,41 NR; Vermesan et al.,43 17%.
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