A Study of Traumatic meniscal tears: Arthroscopic Resection vs Rehabilitation

Rationale: Arthroscopic partial meniscectomy is the most popular intervention under
orthopaedic surgeons to treat patients with meniscal tears. However, cost-effectiveness of
this procedure is seriously questioned. Especially, in case of a traumatic meniscal tear
without locking complaints evidence is lacking whether an arthroscopic intervention is the
most optimal treatment.

Objective: To evaluate the cost-effectiveness of arthroscopic partial meniscectomy
compared to non-operative treatment strategy. The hypothesis is that an arthroscopic partial
meniscectomy is a cost-effective intervention to treat patients with clinical complaints of the
knee because of a traumatic meniscal tear (superiority study).

Study design: Open-labeled randomized clinical trial.

Study population: Patients are eligible in the age of 18-45 years consulting an orthopedic
surgeon with a history of trauma moment after which current signs and symptoms of a
meniscal tear are initiated.

Intervention (if applicable): Patients will be randomized in a) arthroscopic partial
meniscectomy; or in b) non-operative treatment strategy. In group a): arthroscopic treatment
will be performed, followed by an exercise program if indicated according to Dutch guidelines
of physical therapists and orthopedic surgeons. In group b): according to the Dutch guideline
for General Practitioners advice, exercise therapy (standardized program), and pain
medication will be provided.

Main study parameters/endpoints: Difference in clinical outcome measured with
International Knee Documentation Committee questionnaire and information for costeffectiveness
analysis will be assessed over 2 years.

Nature and extent of the burden and risks associated with participation, benefit and
group relatedness: The burden is primarily time (visit of outpatient clinic, and to fill in
questionnaires). There is no direct benefit from participation or group relatedness.

Arthroscopic meniscectomy and non-surgical treatment are both options in the standard care
of active patients, with complaints of a traumatic meniscal tear.

An arthroscopic partial meniscectomy is a cost-effective intervention to treat patients with clinical complaints of the knee because of a traumatic meniscal tear.

3, 6, 9, 12 and 24 months

Physical therapy

Arthroscopic partial meniscectomy