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Arthroscopic partial meniscectomy for degenerative meniscus tears in middle age patients: why surgeons should change their approach
  1. Lars Engebretsen1,
  2. Gilbert Moatshe2
  1. 1 Department of Orthopaedic Surgery, University of Oslo, Oslo, Norway
  2. 2 Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
  1. Correspondence to Dr Lars Engebretsen, Department of Ortho surg, University of Oslo, 0315 Oslo, Norway; lars.engebretsen{at}

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In the interesting linked article,1 authors Dr Raine Sihvonen and colleagues suggest that arthroscopic partial meniscectomy (APM) may lead to long-term harms (by increasing the risk of knee osteoarthritis (OA)) with no clear benefits in patient-reported outcomes. This study was a carefully executed multicentre, randomised, participant-blinded and outcome assessor-blinded, placebo-surgery controlled efficacy trial in participants aged 35 to 65 years who had had knee symptoms for more than 3 months, consistent with the diagnosis of a degenerative medial meniscus tear.1 Participants had not responded to conventional conservative treatment and were free of advanced knee osteoarthritis. A degenerative meniscus tear was verified on both MRI and knee arthroscopy. Patients with an obvious traumatic onset of symptoms or a recent history of a locked knee were excluded. Participants were followed up by questionnaires at 2, 6, 12, 24, 36, 48 and 60 months. At the 24-month and 60-month follow-up, standardised clinical examinations were carried out to …

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  • Twitter @larsengebretsen

  • Contributors Both have written and revised the editorial.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Linked Articles

  • Original research
    Raine Sihvonen Mika Paavola Antti Malmivaara Ari Itälä Antti Joukainen Juha Kalske Heikki Nurmi Jaanika Kumm Niko Sillanpää Tommi Kiekara Aleksandra Turkiewicz Pirjo Toivonen Martin Englund Simo Taimela Teppo L N Järvinen for the FIDELITY (Finnish Degenerative Meniscus Lesion Study) Investigators Anna Ikonen Timo Järvelä Tero AH Järvinen Roope Kalske Kari Kanto Janne Karhunen Jani Knifsund Heikki Kröger Tommi Kääriäinen Janne Lehtinen Jukka Nyrhinen Juha Paloneva Outi Päiväniemi Marko Raivio Janne Sahlman Roope Sarvilinna Sikri Tukiainen Ville-Valtteri Välimäki Ville Äärimaa