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JASON W. DECK, MD, LAMONT CAVANAGH, MD, WILLIAM DUDNEY, MD, JOSHUA HANSEN, MD, THOMAS KERN, MD, AND EMRYS MOREAU, MFA, MLIS

Am Fam Physician. 2024;110(4):421-422

Author disclosure: No relevant financial relationships.

CLINICAL QUESTION

Is arthroscopic surgery superior to physical therapy (PT) for degenerative meniscal tears?

EVIDENCE-BASED ANSWER

Arthroscopic surgery, PT, and exercise can be offered to patients with degenerative meniscal tears; none of these is considered superior. Compared with PT, arthroscopic surgery does not result in any clinically significant differences in pain, symptoms, function, activities of daily living, knee-specific quality of life, or generic quality of life. (Strength of Recommendation [SOR]: A, multiple meta-analyses.) Arthroscopic surgery may worsen range of motion in the knee and cartilage surface area compared with PT. (SOR: C, randomized controlled trials [RCTs].)

EVIDENCE SUMMARY

A 2022 Cochrane review compared arthroscopic surgery for degenerative knee disease with several nonsurgical treatments.1 A subset of the review included five trials comparing arthroscopic surgery plus exercise with exercise alone and three trials comparing arthroscopic surgery with exercise. Seven of the trials included patients with degenerative meniscal tears and excluded patients with severe osteoarthritis (OA).

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Clinical Inquiries provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group (https://www.cebm.net).

The complete database of evidence-based questions and answers is copyrighted by FPIN. If interested in submitting questions or writing answers for this series, go to https://www.fpin.org or email questions@fpin.org.

Copyright © Family Physicians Inquiries Network. Used with permission.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of FPIN’s Clinical Inquiries published in AFP is available at https://www.aafp.org/afp/fpin.

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