Knee Joint Research

Knee Joint Recent Significant Publications

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A Randomized Trial of Physical Therapy for Meniscal Tear and Knee Pain

Background: Physical therapy is routinely recommended for knee pain attributed to a degenerative meniscal tear, but its efficacy has not been established.

Methods: We randomly assigned participants 45 to 85 years of age with knee pain, osteoarthritis, and meniscal tear to one of four groups: home exercise (3-month home-exercise program), home exercise plus text messages to encourage exercise adherence, home exercise plus text messages plus sham physical therapy (in-clinic sham manual therapy and sham ultrasound therapy), and home exercise plus text messages plus standard physical therapy (supervised strengthening, functional, and stretching exercises and manual therapy). The primary outcome was the change in the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscore (range, 0 to 100, with higher scores indicating more pain) between baseline and 3 months, with adjustment for trial site, baseline KOOS pain subscore, and radiographic grade.

Results: A total of 879 participants underwent randomization (mean [±SD] age, 59.2±7.8 years). The difference in the 3-month change in the KOOS pain subscore between home exercise and home exercise plus text messages was -0.1 points (98.3% confidence interval [CI], -3.8 to 3.7) and between home exercise and home exercise plus text messages plus standard physical therapy was 2.5 points (98.3% CI, -1.3 to 6.2); the difference between home exercise plus text messages and home exercise plus text messages plus standard physical therapy was 2.5 points (98.3% CI, -1.4 to 6.5). Adverse events were generally nonserious and evenly distributed overall across groups.

Conclusions: For patients with degenerative meniscal tear and knee pain, the addition of physical therapy or text messages to encourage adherence to home exercises was not superior in reducing pain to a home-exercise program alone. (Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and others; TeMPO ClinicalTrials.gov number, NCT03059004.).

Katz JN, Collins JE, Bisson L, Jones MH, Irrgang JJ, Selzer F, Safran-Norton CE, Spindler KP, Yang HY, Shrestha S, Bennell KL, Sullivan JK, Kluczynski MA, Arant K, Opare-Addo M, Huizinga JL, Zimmerman Z, Sople D, Tonsoline P, Kale M, Wind WM Jr, Chen AF, Freitas M, Lesniak B, Jordan K, Matzkin EG, Dawson C, Farrow L, Musahl V, Leddy JJ, Martin SD, Losina E. A Randomized Trial of Physical Therapy for Meniscal Tear and Knee Pain. N Engl J Med. 2025 Oct 30;393(17):1694-1703. https://www.doi.org/10.1056/NEJMoa2503385. PMID: 41160820

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Using a Combined Inside-Out and All-Inside Technique to Repair Bucket-Handle Medial Meniscal Tears Without a Safety Incision.

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Risk Factors for Readmission following Anterior Cruciate Ligament Reconstruction, J Knee Surg

Best MJ, Harris AB, Marrache M, Martin SD, Rue JPH, Wilckens JH. Risk Factors for Readmission following Anterior Cruciate Ligament Reconstruction. J Knee Surg. [Published Online Ahead of Print 2021 Oct 5] doi:10.1055/s-0041-1736200 PubMed PMID: 34610639.

Conclusion: Readmission after ACL reconstruction was 1.2%. The strongest risk factors for 90-day readmission include cerebrovascular disease, diabetes mellitus, concomitant MCL/LCL reconstruction, concomitant PCL reconstruction, and age between 44 and 65 years. Readmission was associated with substantial health care costs.

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Association Between “Meniscal symptoms” and Outcomes of Operative and Non-Operative Treatment of Meniscal Tear in Patients with Osteoarthritis. Arthritis Care Res (Hoboken)

MacFarlane LA, Yang H, Collins J, Brophy R, Cole B, Spindler K, Guermazi A, Jones M, Mandl L, Martin SD, Marx R, Levy B, Stuart MJ, Safran-Norton C, Wright J, Wright R, Losina E, Katz J. Association Between “Meniscal symptoms” and Outcomes of Operative and Non-Operative Treatment of Meniscal Tear in Patients with Osteoarthritis. Arthritis Care Res (Hoboken). 2021 Mar 1;10.1002/acr.24588. doi:10.1002/acr.24588.

Conclusion: “Meniscal symptoms” were not associated with improved pain relief. Although symptoms of clicking and intermittent locking had a greater reduction in the APM group, the presence of “meniscal symptoms” in isolation should not inform clinical decisions surrounding APM vs. PT in patients with meniscal tear and knee OA.

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Early Magnetic Resonance Imaging-Based Changes in Patients With Meniscal Tear and Osteoarthritis: Eighteen-Month Data From a Randomized Controlled Trial of Arthroscopic Partial Meniscectomy Versus Physical Therapy. Arthritis Care Res (Hoboken)

Collins JE, Losina E, Marx RG, Guermazi A, Jarraya M, Jones MH, Levy BA, Mandl LA, Martin SD, Wright RW, Spindler KP, Katz JN; MeTeOR Investigator Group. Early Magnetic Resonance Imaging-Based Changes in Patients With Meniscal Tear and Osteoarthritis: Eighteen-Month Data From a Randomized Controlled Trial of Arthroscopic Partial Meniscectomy Versus Physical Therapy. Arthritis Care Res (Hoboken). 2020 May;72(5):630-640. doi:10.1002/acr.23891.

Conclusion: This cohort of patients with meniscal tear and osteoarthritis showed marked advancement in MRI-based features over 18 months. Patients treated with APM showed more advancement in some features compared to those treated nonoperatively. The clinical relevance of these early findings is unknown and requires further study.

Knee Joint Surgical Technique Videos

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Using a Combined Inside-Out and All-Inside Technique to Repair Bucket-Handle Medial Meniscal Tears Without a Safety Incision.