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Effect of arthroscopic partial meniscectomy on structural degeneration of the knee – A 5-year MRI-based follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial

Sillanpää, Niko ; Iivanainen, Marika ; Turkiewicz, Aleksandra LU ; Sihvonen, Raine ; Paavola, Mika ; Taimela, Simo ; Järvinen, Teppo L.N. and Englund, Martin LU orcid (2024) In Osteoarthritis and Cartilage
Abstract

Objective: To assess the 5-year effects of arthroscopic partial meniscectomy (APM) vs. placebo surgery on the development of the structural changes of the knee by magnetic resonance imaging (MRI). Design: This multicentre, randomized, participant- and outcome-assessor-blinded, placebo-surgery-controlled trial was carried out in Finland. We randomized 146 adults, mean age 52 years (range 35 to 65) to undergo either APM or placebo surgery. The subjects had symptoms of degenerative medial meniscus tear, a tear verified in MRI and arthroscopy, and no advanced osteoarthritis at baseline. We compared the baseline and 5-year follow-up MRIs using MRI Osteoarthritis Knee Score scoring to derive subregional data on cartilage damage, osteophytes... (More)

Objective: To assess the 5-year effects of arthroscopic partial meniscectomy (APM) vs. placebo surgery on the development of the structural changes of the knee by magnetic resonance imaging (MRI). Design: This multicentre, randomized, participant- and outcome-assessor-blinded, placebo-surgery-controlled trial was carried out in Finland. We randomized 146 adults, mean age 52 years (range 35 to 65) to undergo either APM or placebo surgery. The subjects had symptoms of degenerative medial meniscus tear, a tear verified in MRI and arthroscopy, and no advanced osteoarthritis at baseline. We compared the baseline and 5-year follow-up MRIs using MRI Osteoarthritis Knee Score scoring to derive subregional data on cartilage damage, osteophytes and bone marrow lesions (BMLs). Progression of structural cartilage changes analyzed per subregion was the main outcome, that of osteophytes and BMLs secondary outcomes. We analyzed the progression with multilevel logistic regression model on subregion-level data, adjusted for randomization stratification factors, and using robust standard errors. Results: Sixty-three (90%) subjects in the APM and 73 (96%) in the placebo-surgery group had MRI at both time points. The adjusted odds ratio (APM vs. placebo-surgery) was 1.31 (95% confidence interval 0.81, 1.94) for progression of cartilage damage, 2.86 (1.16, 6.21) for osteophytes, and 1.43 (0.84, 2.43) for BMLs. Conclusions: We found a slightly greater risk for progression of osteophytes in the APM group compared to the placebo-surgery group at 5 years after surgery. Trial registration: ClinicalTrials.gov (NCT01052233 and NCT00549172).

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Knee, Knee arthroscopy, Magnetic resonance imaging, Meniscus, Osteoarthritis, Placebo surgery
in
Osteoarthritis and Cartilage
publisher
W.B. Saunders
external identifiers
  • scopus:85204486509
  • pmid:39277028
ISSN
1063-4584
DOI
10.1016/j.joca.2024.09.003
language
English
LU publication?
yes
id
ad3a9877-6221-4c7d-a092-411d36717041
date added to LUP
2024-11-27 11:43:40
date last changed
2025-06-12 03:28:34
@article{ad3a9877-6221-4c7d-a092-411d36717041,
  abstract     = {{<p>Objective: To assess the 5-year effects of arthroscopic partial meniscectomy (APM) vs. placebo surgery on the development of the structural changes of the knee by magnetic resonance imaging (MRI). Design: This multicentre, randomized, participant- and outcome-assessor-blinded, placebo-surgery-controlled trial was carried out in Finland. We randomized 146 adults, mean age 52 years (range 35 to 65) to undergo either APM or placebo surgery. The subjects had symptoms of degenerative medial meniscus tear, a tear verified in MRI and arthroscopy, and no advanced osteoarthritis at baseline. We compared the baseline and 5-year follow-up MRIs using MRI Osteoarthritis Knee Score scoring to derive subregional data on cartilage damage, osteophytes and bone marrow lesions (BMLs). Progression of structural cartilage changes analyzed per subregion was the main outcome, that of osteophytes and BMLs secondary outcomes. We analyzed the progression with multilevel logistic regression model on subregion-level data, adjusted for randomization stratification factors, and using robust standard errors. Results: Sixty-three (90%) subjects in the APM and 73 (96%) in the placebo-surgery group had MRI at both time points. The adjusted odds ratio (APM vs. placebo-surgery) was 1.31 (95% confidence interval 0.81, 1.94) for progression of cartilage damage, 2.86 (1.16, 6.21) for osteophytes, and 1.43 (0.84, 2.43) for BMLs. Conclusions: We found a slightly greater risk for progression of osteophytes in the APM group compared to the placebo-surgery group at 5 years after surgery. Trial registration: ClinicalTrials.gov (NCT01052233 and NCT00549172).</p>}},
  author       = {{Sillanpää, Niko and Iivanainen, Marika and Turkiewicz, Aleksandra and Sihvonen, Raine and Paavola, Mika and Taimela, Simo and Järvinen, Teppo L.N. and Englund, Martin}},
  issn         = {{1063-4584}},
  keywords     = {{Knee; Knee arthroscopy; Magnetic resonance imaging; Meniscus; Osteoarthritis; Placebo surgery}},
  language     = {{eng}},
  publisher    = {{W.B. Saunders}},
  series       = {{Osteoarthritis and Cartilage}},
  title        = {{Effect of arthroscopic partial meniscectomy on structural degeneration of the knee – A 5-year MRI-based follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial}},
  url          = {{http://dx.doi.org/10.1016/j.joca.2024.09.003}},
  doi          = {{10.1016/j.joca.2024.09.003}},
  year         = {{2024}},
}