Early Surgery Versus Conservative Therapy for Meniscal Injuries in Older Patients

Summary

The purpose of this study is to determine the effectiveness of both arthroscopic knee surgery and physical therapy in the treatment of non-obstructive meniscal injuries in older patients.

The investigators assume equal improvement of physical function in both groups and reduced costs with conservative treatment.

Conditions

• Meniscal Tear

Interventions

PROCEDURE

Arthroscopic Partial Meniscectomy

Arthroscopic partial APM is performed within 4 weeks in day-care. No standard physical therapy is prescribed after surgery, as advised by the Dutch Orthopaedic Association Guidelines.

OTHER

Physical Therapy

Conservative treatment consist of 16 sessions PT and a home exercise program. These programs are developed for our population, 45-70 years, with a focus on closed-chain strength exercises and cardiovascular exercises. In case conservative treatment has failed, patients can cross-over and delayed APM is then performed. This can be done, from completion of the PT program, during the entire study.

Sponsors & Collaborators

• ZonMw: The Netherlands Organisation for Health Research and Development

  collaborator OTHER

• Stichting Achmea Gezondheidszor

  collaborator OTHER

• Onze Lieve Vrouwe Gasthuis

  lead OTHER

Principal Investigators

• Rudolf W Poolman, MD PhD · Dept. Orthopaedic Surgery Onze Lieve Vrouwe Gasthuis

• Arthur de Gast, MD PhD · Dept. Orthopaedic Surgery Diakonessenhuis, Utrecht

• Thijs ThM van der SChoot, MD PhD · Dean Board of Directors Onze Lieve Vrouwe Gasthuis

• Eduard LA Mutsaerts, MD PhD · Dept. of Orthopaedic Surgery Onze Lieve Vrouwe Gasthuis

• Victor A van de Graaf, MD · Dept. of Orthopaedic Surgery Onze Lieve Vrouwe Gasthuis

• Gino MM Kerkhoffs, MD PhD · Dept. of Orthopaedic Surgery Academic Medical Center University of Amsterdam

• Julius Wolkenfelt, MD · Dept. of Orthopaedic Surgery St. Lucas Andreas Hospital

• Maurits W van Tulder, professor · Professor of Health Technology Assessment Dept. Health Sciences VU University Amsterdam

• Vanessa AB Scholtes, PhD · Research coordinator Dept. of Orthopaedic Surgery Onze Lieve Vrouwe Gasthuis

• Nienke Wolterbeek, PhD · Research coordinator Dept. of Orthopaedic Surgery St. Antonius Hospital

• Camille Neeter, PhD · Neeter Physiotherapy Amsterdam

• Ewoud RA van Arkel, MD PhD · Dept. of Orthopaedic Surgery MC Haaglanden

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

45 Years

Max Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2013-07-31

Primary Completion

2017-09-30

Completion

2017-10-31

Countries

• Netherlands

Study Locations