A Randomized Trial of Physical Therapy for Meniscal Tear and Knee Pain
Year: 2025
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: BACKGROUND: Physical therapy is routinely recommended for knee pain attributed to a degenerative meniscal tear, but its efficacy has not been established. METHODS: We randomly assigned participants 45 to 85 years of age with knee pain, osteoarthritis, and meniscal tear to one of four groups: home exercise (3-month home-exercise program), home exercise plus text messages to encourage exercise adherence, home exercise plus text messages plus sham physical therapy (in-clinic sham manual therapy and sham ultrasound therapy), and home exercise plus text messages plus standard physical therapy (supervised strengthening, functional, and stretching exercises and manual therapy). The primary outcome was the change in the Knee Injury and Osteoarthritis Outcome Score (KOOS) pain subscore (range, 0 to 100, with higher scores indicating more pain) between baseline and 3 months, with adjustment for trial site, baseline KOOS pain subscore, and radiographic grade. RESULTS: A total of 879 participants underwent randomization (mean [±SD] age, 59.2±7.8 years). The difference in the 3-month change in the KOOS pain subscore between home exercise and home exercise plus text messages was -0.1 points (98.3% confidence interval [CI], -3.8 to 3.7) and between home exercise and home exercise plus text messages plus standard physical therapy was 2.5 points (98.3% CI, -1.3 to 6.2); the difference between home exercise plus text messages and home exercise plus text messages plus standard physical therapy was 2.5 points (98.3% CI, -1.4 to 6.5). Adverse events were generally nonserious and evenly distributed overall across groups. CONCLUSIONS: For patients with degenerative meniscal tear and knee pain, the addition of physical therapy or text messages to encourage adherence to home exercises was not superior in reducing pain to a home-exercise program alone. (Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and others; TeMPO ClinicalTrials.gov number, NCT03059004.).
Source: New England Journal of Medicine
Authors: Jeffrey N. Katz, Jamie E. Collins, Leslie Bisson, Morgan H. Jones, James J. Irrgang, Faith Selzer, Clare E. Safran-Norton, Kurt P. Spindler, Heidi Y. Yang, Swastina Shrestha, Kim L. Bennell, James K. Sullivan, Melissa A. Kluczynski, Kaetlyn Arant, Maame Opare-Addo, Jamie L. Huizinga, Zoe Zimmerman, Derek Sople, Peter Tonsoline, Madhuri Kale, William M. Wind, Antonia F. Chen, Michael Freitas, Bryson Lesniak, Kelly Jordan, Elizabeth G. Matzkin, Courtney Dawson, Lutul Farrow, Volker Musahl, John J. Leddy, Scott D. Martin, Elena Losina
Institutions: Brigham and Women's Hospital, Harvard University, University at Buffalo, State University of New York, University of Pittsburgh, Cleveland Clinic Lerner College of Medicine, The University of Melbourne, The University of Texas Southwestern Medical Center, Massachusetts General Hospital
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Randomized Trial of Non-Operative Therapies for Degenerative Meniscal Tear, G1585857839, G1743633091, Data-driven approaches in defining knee osteoarthritis phenotypes and factorsassociated with fast progression, Treatment of Meniscal Problems in Osteoarthritis: TeMPO, VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYtics
OpenAlex ID: W4415677312