المؤلفون: Schoenfeld, Andrew J., Losina, Elena, Ferrone, Marco L., Schwab, Joseph H., Chi, John H., Blucher, Justin A., Silva, Genevieve S., Chen, Angela T., Harris, Mitchel B., Kang, James D., Katz, Jeffrey N.

المصدر: Cancer (0008543X); Aug2019, Vol. 125 Issue 15, p2631-2637, 7p

مصطلحات موضوعية: THERAPEUTICS, PROPENSITY score matching, LIFE expectancy, ONCOLOGY, METASTASIS

مستخلص: Background: Decisions for operative or nonoperative management remain challenging for patients with spinal metastases, especially when life expectancy and quality of life are not easily predicted. This study evaluated the effects of operative and nonoperative management on maintenance of ambulatory function and survival for patients treated for spinal metastases. Methods: Propensity matching was used to yield an analytic sample in which operatively and nonoperatively treated patients were similar with respect to key baseline covariates. The study included patients treated for spinal metastases between 2005 and 2017 who were 40 to 80 years old, were independent ambulators at presentation, and had fewer than 5 medical comorbidities. It evaluated the influence of operative care and nonoperative care on ambulatory function 6 months after presentation as the primary outcome. Survival at 6 months and survival at 1 year were secondary outcomes. Results: Nine hundred twenty‐nine individuals eligible for inclusion were identified, with 402 (201 operative patients and 201 nonoperative patients) retained after propensity score matching. Patients treated operatively had a lower likelihood than those treated nonoperatively of being nonambulatory 6 months after presentation (3% vs 16%; relative risk [RR], 0.16; 95% confidence interval [CI], 0.06‐0.46) as well as a reduced risk of 6‐month mortality (20% vs 29%; RR, 0.69; 95% CI, 0.49‐0.98). Conclusions: These results indicate that in a group of patients with similar demographic and clinical characteristics, those treated operatively were less likely to lose ambulatory function 6 months after presentation than those managed nonoperatively. For patients with spinal metastases, our data can be incorporated into discussions about the treatments that align best with patients' preferences regarding surgical risk, mortality, and ambulatory status. This cohort study uses propensity matching to yield an analytic sample in which operatively and nonoperatively treated patients are similar with respect to key baseline covariates, including the independent ambulatory status at presentation. The results indicate that patients treated operatively are less likely to lose ambulatory function 6 months after presentation than those managed nonoperatively. [ABSTRACT FROM AUTHOR]

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المؤلفون: MacFarlane, Lindsey A., Yang, Heidi, Collins, Jamie E., Guermazi, Ali, Jones, Morgan H., Spindler, Kurt P., Winter, Amelia R., Losina, Elena, Katz, Jeffrey N., Brophy, Robert H., Cole, Brian J., Levy, Bruce A., Mandl, Lisa A., Martin, Scott, Marx, Robert G., Matava, Mathew, Safran-Norton, Clare, Stuart, Michael, Wright, Rick

المصدر: American Journal of Sports Medicine; Mar2019, Vol. 47 Issue 3, p612-619, 8p

مصطلحات موضوعية: OSTEOARTHRITIS treatment, MENISCUS injuries, KNEE diseases, ARTHROSCOPY, LONGITUDINAL method, MAGNETIC resonance imaging, MENISCECTOMY, PHYSICAL therapy, REGRESSION analysis, BODY mass index, KNEE pain, DESCRIPTIVE statistics, THERAPEUTICS

مستخلص: Background: Arthroscopic partial meniscectomy (APM) is used to treat meniscal tears, although its efficacy is controversial. Purpose: This study used magnetic resonance imaging (MRI) to determine characteristics that lead to greater benefit from APM and physical therapy (PT) than from PT alone among patients with meniscal tear and knee osteoarthritis. Study Design: Cohort study; Level of evidence, 2. Methods: Using data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial, the authors first assessed whether the effect of treatment on pain scores at 6 months differed according to baseline MRI features (bone marrow lesions, cartilage and meniscal damage). Second, the authors summed MRI features associated with differential pain relief between APM and PT to create a "damage score," which included bone marrow lesion number and cartilage damage size with possible values of 0 (least damage), 1 (moderate), and 2 (greatest). The authors used linear models to determine whether the association between damage score and pain relief at 6 months differed for APM versus PT. Results: The study included 220 participants: 13%, had the least damage; 52%, moderate; and 34%, greatest. Although treatment type did not significantly modify the association of damage score and change in pain (P interaction = .13), those with the least damage and moderate damage had greater improvement with APM than with PT in Knee injury and Osteoarthritis Outcome Score pain subscale—by 15 and 7 points, respectively. Those with the greatest damage had a similar improvement with APM and PT. Conclusion: Among patients with osteoarthritis and meniscal tear, those with less intra-articular damage on MRI may have greater improvement in pain with APM and PT than with PT alone. However, these results should be interpreted cautiously owing to the limited sample size. [ABSTRACT FROM AUTHOR]

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المؤلفون: MacFarlane, Lindsey A., Yang, Heidi, Collins, Jamie E., Jarraya, Mohamed, Guermazi, Ali, Mandl, Lisa A., Martin, Scott D., Wright, John, Losina, Elena, Katz, Jeffrey N., Brophy, Robert H., Levy, Bruce A., Marx, Robert G., Matava, Mathew, Safran‐Norton, Clare, Spindler, Kurt P., Stuart, Michael, Dahm, Diane L., Wright, Rick

المصدر: Arthritis & Rheumatology; Jan2019, Vol. 71 Issue 1, p73-81, 9p

مصطلحات موضوعية: CARTILAGE diseases, CONFIDENCE intervals, KNEE diseases, MAGNETIC resonance imaging, MENISCUS injuries, OSTEOARTHRITIS, PHYSICAL therapy, POISSON distribution, REGRESSION analysis, RELATIVE medical risk, SYNOVITIS, DISEASE progression, DISEASE complications, DISEASE risk factors, DIAGNOSIS, THERAPEUTICS

مستخلص: Objective: Synovitis is a feature of knee osteoarthritis (OA) and meniscal tear and has been associated with articular cartilage damage. This study was undertaken to examine the associations of baseline effusion‐synovitis and changes in effusion‐synovitis with changes in cartilage damage in a cohort with OA and meniscal tear. Methods: We analyzed data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial of surgery versus physical therapy for treatment of meniscal tear. We performed semiquantitative grading of effusion‐synovitis and cartilage damage on magnetic resonance imaging, and dichotomized effusion‐synovitis as none/small (minimal) and medium/large (extensive). We assessed the association of baseline effusion‐synovitis and changes in effusion‐synovitis with changes in cartilage damage size and depth over 18 months, using Poisson regression models. Analyses were adjusted for patient demographic characteristics, treatment, and baseline cartilage damage. Results: We analyzed 221 participants. Over 18 months, effusion‐synovitis was persistently minimal in 45.3% and persistently extensive in 21.3% of the patients. The remaining 33.5% of the patients had minimal synovitis on one occasion and extensive synovitis on the other. In adjusted analyses, patients with extensive effusion‐synovitis at baseline had a relative risk (RR) of progression of cartilage damage depth of 1.7 (95% confidence interval [95% CI] 1.0–2.7). Compared to those with persistently minimal effusion‐synovitis, those with persistently extensive effusion‐synovitis had a significantly increased risk of progression of cartilage damage depth (RR 2.0 [95% CI 1.1–3.4]). Conclusion: Our findings indicate that the presence of extensive effusion‐synovitis is associated with subsequent progression of cartilage damage over 18 months. The persistence of extensive effusion‐synovitis over time is associated with the greatest risk of concurrent cartilage damage progression. [ABSTRACT FROM AUTHOR]

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المؤلفون: Messier, Stephen P., Callahan, Leigh F., Beavers, Daniel P., Queen, Kate, Mihalko, Shannon L., Miller, Gary D., Losina, Elena, Katz, Jeffrey N., Loeser, Richard F., Quandt, Sara A., DeVita, Paul, Hunter, David J., Lyles, Mary F., Newman, Jovita, Hackney, Betsy, Jordan, Joanne M.

المصدر: BMC Musculoskeletal Disorders; 2/22/2017, Vol. 18, p1-14, 14p, 3 Diagrams, 6 Charts

مصطلحات موضوعية: ARTHRITIS diagnosis, PRAGMATICS, RANDOMIZED controlled trials, CLINICAL medicine research, SOCIOECONOMIC factors, OSTEOARTHRITIS treatment, REDUCING diets, PAIN management, OBESITY complications, CONVALESCENCE, EXERCISE therapy, KNEE diseases, OSTEOARTHRITIS, PAIN, QUALITY of life, SELF-evaluation, WEIGHT loss, PAIN measurement, LIFESTYLES, TREATMENT effectiveness, DISEASE complications, THERAPEUTICS

مصطلحات جغرافية: NORTH Carolina

مستخلص: Background: Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown. Thus, the policy relevant and clinically important question is: Can we adapt this successful solution to a pervasive public health problem in real-world clinical and community settings? This study aims to develop a systematic, practical, cost-effective diet-induced weight loss and exercise intervention implemented in community settings and to determine its effectiveness in reducing pain and improving other clinical outcomes in persons with knee OA.Methods/design: This is a Phase III, pragmatic, assessor-blinded, randomized controlled trial. Participants will include 820 ambulatory, community-dwelling, overweight and obese (BMI ≥ 27 kg/m2) men and women aged ≥ 50 years who meet the American College of Rheumatology clinical criteria for knee OA. The primary aim is to determine whether a community-based 18-month diet-induced weight loss and exercise intervention based on social cognitive theory and implemented in three North Carolina counties with diverse residential (from urban to rural) and socioeconomic composition significantly decreases knee pain in overweight and obese adults with knee OA relative to a nutrition and health attention control group. Secondary aims will determine whether this intervention improves self-reported function, health-related quality of life, mobility, and is cost-effective.Discussion: Many physicians who treat people with knee OA have no practical means to implement weight loss and exercise treatments as recommended by numerous OA treatment guidelines. This study will establish the effectiveness of a community program that will serve as a blueprint and exemplar for clinicians and public health officials in urban and rural communities to implement a diet-induced weight loss and exercise program designed to reduce knee pain and improve other clinical outcomes in overweight and obese adults with knee OA.Trial Registration: clinicaltrials.gov Identifier: NCT02577549 October 12, 2015. [ABSTRACT FROM AUTHOR]

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المؤلفون: Smith, Savannah R., Katz, Jeffrey N., Collins, Jamie E., Solomon, Daniel H., Jordan, Joanne M., Suter, Lisa G., Yelin, Edward H., David Paltiel, A., Losina, Elena

المصدر: Arthritis Care & Research; Feb2017, Vol. 69 Issue 2, p234-242, 9p

مصطلحات موضوعية: THERAPEUTIC use of narcotics, ANALGESICS, COMPUTER simulation, COST effectiveness, KNEE diseases, NARCOTICS, OSTEOARTHRITIS, RESEARCH funding, OXYCODONE, FERRANS & Powers Quality of Life Index, TRAMADOL, IMPACT of Event Scale, ECONOMICS, THERAPEUTICS

مستخلص: Objective: To evaluate the cost-effectiveness of incorporating tramadol or oxycodone into knee osteoarthritis (OA) treatment.Methods: We used the Osteoarthritis Policy Model to evaluate long-term clinical and economic outcomes of knee OA patients with a mean age of 60 years with persistent pain despite conservative treatment. We evaluated 3 strategies: opioid-sparing (OS), tramadol (T), and tramadol followed by oxycodone (T+O). We obtained estimates of pain reduction and toxicity from published literature and annual costs for tramadol ($600) and oxycodone ($2,300) from Red Book Online. Based on published data, in the base case, we assumed a 10% reduction in total knee arthroplasty (TKA) effectiveness in opioid-based strategies. Outcomes included quality-adjusted life years (QALYs), lifetime cost, and incremental cost-effectiveness ratios (ICERs) and were discounted at 3% per year.Results: In the base case, T and T+O strategies delayed TKA by 7 and 9 years, respectively, and led to reduction in TKA utilization by 4% and 10%, respectively. Both opioid-based strategies increased cost and decreased QALYs compared to the OS strategy. Tramadol's ICER was highly sensitive to its effect on TKA outcomes. Reduction in TKA effectiveness by 5% (compared to base case 10%) resulted in an ICER for the T strategy of $110,600 per QALY; with no reduction in TKA effectiveness, the ICER was $26,900 per QALY. When TKA was not considered a treatment option, the ICER for T was $39,600 per QALY.Conclusion: Opioids do not appear to be cost-effective in OA patients without comorbidities, principally because of their negative impact on pain relief after TKA. The influence of opioids on TKA outcomes should be a research priority. [ABSTRACT FROM AUTHOR]

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المؤلفون: Katz, Jeffrey N.^1,2,3,4,5,6 jnkatz@partners.org, Wright, John^1,2,3,4,5,6, Spindler, Kurt P.^1,2,3,4,5,6, Mandl, Lisa A.^1,2,3,4,5,6, Safran-Norton, Clare E.^1,2,3,4,5,6, Reinke, Emily K.^1,2,3,4,5,6, Levy, Bruce A.^1,2,3,4,5,6, Wright, Rick W.^1,2,3,4,5,6, Jones, Morgan H.^1,2,3,4,5,6, Martin, Scott D.^1,2,3,4,5,6, Marx, Robert G.^1,2,3,4,5,6, Losina, Elena^1,2,3,4,5,6

المصدر: Journal of Bone & Joint Surgery, American Volume. 11/16/2016, Vol. 98 Issue 22, p1890-1896. 7p.

مصطلحات موضوعية: *OSTEOARTHRITIS treatment, *MENISCECTOMY, *DISEASE duration, *PAIN management, *TREATMENT effectiveness, *KNEE surgery, *COMPARATIVE studies, *CONVALESCENCE, *CROSSOVER trials, *KNEE diseases, *RESEARCH methodology, *MEDICAL cooperation, *ORTHOPEDIC surgery, *OSTEOARTHRITIS, *PHYSICAL therapy, *PROGNOSIS, *QUESTIONNAIRES, *RESEARCH, *RESEARCH funding, *ACTIVITIES of daily living, *EVALUATION research, *PAIN measurement, *RANDOMIZED controlled trials, *THERAPEUTICS

مستخلص: Background: Arthroscopic partial meniscectomy (APM) combined with physical therapy (PT) have yielded pain relief similar to that provided by PT alone in randomized trials of subjects with a degenerative meniscal tear. However, many patients randomized to PT received APM before assessment of the primary outcome. We sought to identify factors associated with crossing over to APM and to compare pain relief between patients who had crossed over to APM and those who had been randomized to APM.Methods: We used data from the MeTeOR (Meniscal Tear in Osteoarthritis Research) Trial of APM with PT versus PT alone in subjects ≥45 years old who had mild-to-moderate osteoarthritis and a degenerative meniscal tear. We assessed independent predictors of crossover to APM among those randomized to PT. We also compared pain relief at 6 months among those randomized to PT who crossed over to APM, those who did not cross over, and those originally randomized to APM.Results: One hundred and sixty-four subjects were randomized to and received APM and 177 were randomized to PT, of whom 48 (27%) crossed over to receive APM in the first 140 days after randomization. In multivariate analyses, factors associated with a higher likelihood of crossing over to APM among those who had originally been randomized to PT included a baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Score of ≥40 (risk ratio [RR] = 1.99; 95% confidence interval [CI] = 1.00, 3.93) and symptom duration of <1 year (RR = 1.74; 95% CI = 0.98, 3.08). Eighty-one percent of subjects who crossed over to APM and 82% of those randomized to APM had an improvement of ≥10 points in their pain score at 6 months, as did 73% of those who were randomized to and received only PT.Conclusions: Subjects who crossed over to APM had presented with a shorter symptom duration and greater baseline pain than those who did not cross over from PT. Subjects who crossed over had rates of surgical success similar to those of the patients who had been randomized to surgery. Our findings also suggest that an initial course of rigorous PT prior to APM may not compromise surgical outcome.Level Of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

المؤلفون: Allen, Kelli D., Sanders, Linda L., Olsen, Maren K., Bowlby, Lynn, Katz, Jeffrey N., Mather, Richard C., Williams, John W.

المصدر: Musculoskeletal Care; Jun2016, Vol. 14 Issue 2, p87-97, 11p

مصطلحات موضوعية: HIP joint diseases, KNEE disease treatment, OSTEOARTHRITIS treatment, DECISION making, INTERNET, PATIENT education, PROBABILITY theory, STATISTICAL sampling, WHITE people, DVD-Video discs, DESCRIPTIVE statistics, MANN Whitney U Test, PATIENT decision making, THERAPEUTICS

مستخلص: Introduction Decision aids (DAs) can improve multiple decision-making outcomes, but it is not known whether different formats of delivery differ in their effectiveness or acceptability. The present study compared the effectiveness and acceptability of internet and DVD formats of DAs for osteoarthritis (OA). Methods Patients with hip or knee OA were randomized to view an internet or DVD format DA, which provided information on OA treatments. Measures were collected at baseline, immediately after viewing the DA and then 30 days later. Outcomes included: Hip/Knee OA Decision Quality Instrument - Knowledge Subscale (HK-DQI Knowledge), Decisional Conflict Scale (DCS), Preparation for Decision Making Scale (PDMS), Stage of Decision Making, and Acceptability of DAs. Generalized estimating equations (GEE) were used to examine changes in HK-DQI Knowledge and DCS scores over time, between decision aid groups and within the sample overall. Group differences in the PDMS scale (assessed once, immediately after DA viewing) were estimated using a Wilcoxon rank sums test. Results Among 155 participants in the study, the mean age was 61.8 years, 60.6% were women and 58.1% were Caucasian. HK-DQI Knowledge scores improved over time ( p < 0.001), although there was some attenuation by the 30-day follow-up; there was no difference between the two DA groups ( p = 0.448). DCS scores decreased markedly for both groups ( p < 0.001) and improvements were maintained by the 30-day follow-up (means: internet: baseline = 25.0, 30-day = 6.9; DVD: baseline = 25.0, 30-day = 6.2); there was no difference between the two DA groups ( p = 0.808). PDMS scores were higher for the DVD group than the internet group (85.2 versus 74.9, p = 0.005). Stage of Decision Making became more certain after viewing the DA for both groups, with even more certainty indicated at 30-day follow-up. Acceptability items indicated positive perceptions of both DAs. Discussion Internet and DVD DAs were associated with meaningful, comparable improvements in decision-making outcomes in patients with knee and hip OA. DAs are inexpensive to disseminate and could be valuable tools for enhancing care for OA. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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المؤلفون: Nazarian, Ara, Entezari, Vahid, Villa-Camacho, Juan, Zurakowski, David, Katz, Jeffrey, Hochman, Mary, Baldini, Elizabeth, Vartanians, Vartan, Rosen, Max, Gebhardt, Mark, Terek, Richard, Damron, Timothy, Yaszemski, Michael, Snyder, Brian, Villa-Camacho, Juan C, Katz, Jeffrey N, Baldini, Elizabeth H, Rosen, Max P, Gebhardt, Mark C, Terek, Richard M

المصدر: Clinical Orthopaedics & Related Research®; Mar2016, Vol. 474 Issue 3, p652-659, 8p

مصطلحات موضوعية: COMPUTED tomography, BONE metastasis, MEDICAL decision making, RISK factors of fractures, DIAGNOSIS, THERAPEUTICS, BONE tumors, FOCUS groups, SPONTANEOUS fractures, RESEARCH funding, RISK assessment, PILOT projects, PREDICTIVE tests

مستخلص: Background: There is a need to improve the prediction of fracture risk for patients with metastatic bone disease. CT-based rigidity analysis (CTRA) is a sensitive and specific method, yet its influence on clinical decision-making has never been quantified.Questions/purposes: What is the influence of CTRA on providers' perceived risk of fracture? (2) What is the influence of CTRA on providers' treatment recommendations in simulated clinical scenarios of metastatic bone disease of the femur? (3) Does CTRA improve interobserver agreement regarding treatment recommendations?Methods: We conducted a survey among 80 academic physicians (orthopaedic oncologists, musculoskeletal radiologists, and radiation oncologists) using simulated vignettes of femoral lesions presented as three separate scenarios: (1) no CTRA input (baseline); (2) CTRA input suggesting increased risk of fracture (CTRA+); and (3) CTRA input suggesting decreased risk of fracture (CTRA-). Participants were asked to rate the patient's risk of fracture on a scale of 0% to 100% and to provide a treatment recommendation. Overall response rate was 62.5% (50 of 80).Results: When CTRA suggested an increased risk of fracture, physicians perceived the fracture risk to be slightly greater (37% ± 3% versus 42% ± 3%, p < 0.001; mean difference [95% confidence interval {CI}] = 5% [4.7%-5.2%]) and were more prone to recommend surgical stabilization (46% ± 9% versus 54% ± 9%, p < 0.001; mean difference [95% CI] = 9% [7.9-10.1]). When CTRA suggested a decreased risk of fracture, physicians perceived the risk to be slightly decreased (37% ± 25% versus 35% ± 25%, p = 0.04; mean difference [95% CI] = 2% [2.74%-2.26%]) and were less prone to recommend surgical stabilization (46% ± 9% versus 42% ± 9%, p < 0.03; mean difference [95% CI] = 4% [3.9-5.1]). The effect size of the influence of CTRA on physicians' perception of fracture risk and treatment planning varied with lesion severity and specialty of the responders. CTRA did not increase interobserver agreement regarding treatment recommendations when compared with the baseline scenario (κ = 0.41 versus κ = 0.43, respectively).Conclusions: Based on this survey study, CTRA had a small influence on perceived fracture risk and treatment recommendations and did not increase interobserver agreement. Further work is required to properly introduce this technique to physicians involved in the care of patients with metastatic lesions. Given the number of preclinical and clinical studies outlining the efficacy of this technique, better education through presentations at seminars/webinars and symposia will be the first step. This should be followed by clinical trials to establish CTRA-based clinical guidelines based on evidence-based medicine. Increased exposure of clinicians to CTRA, including its underlying methodology to study bone structural characteristics, may establish CTRA as a uniform guideline to assess fracture risk.Level Of Evidence: Level III, economic and decision analyses. [ABSTRACT FROM AUTHOR]

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المؤلفون: Ramirez-Avila, Lynn, Regan, Susan, Chetty, Senica, Giddy, Janet, Ross, Douglas, Katz, Jeffrey N., Freedberg, Kenneth A., Losina, Elena, Walensky, Rochelle P., Bassett, Ingrid V.

المصدر: International Journal of STD & AIDS; Sep2015, Vol. 26 Issue 10, p704-709, 6p, 1 Chart, 1 Graph

مصطلحات موضوعية: DIAGNOSIS of HIV infections, HIV infections, THERAPEUTICS, HIV infection transmission, HIV-positive persons, HEALTH

مصطلحات جغرافية: DURBAN (South Africa)

مستخلص: The HIV public health messages in South Africa have increased. Our objective was to evaluate changes over time in HIV testing behaviour, prevalence and knowledge. We prospectively enrolled adults (≥18 years) prior to HIV testing at one urban and one peri-urban outpatient department in Durban, South Africa. A baseline questionnaire administered before testing included the number of prior HIV tests and four knowledge items. We used test results to estimate previously undiagnosed HIV prevalence among those tested. We assessed linear trends over enrollment. From November 2006 to August 2010, 5229 subjects enrolled and 4877 (93%) were HIV tested and had results available. Subjects reporting prior testing over time increased, from 13% in study year 1 to 42% in year 4 (linear trend p < 0.001). The HIV prevalence among those tested declined steadily and significantly over time, from 64% of enrollees in study year 1 to 39% in the final year (linear trend p < 0.001). The percentage of subjects who recognised that medicine can help people with HIV live longer increased from 80% in study year 1 to 96% in study year 4. Rates of HIV testing have increased and prevalence among those tested has decreased in outpatients in Durban, South Africa. [ABSTRACT FROM AUTHOR]

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المؤلفون: Katz, Jeffrey N.¹ jnkatz@partners.org, Brophy, Robert H.², Chaisson, Christine E.³, de Chaves, Leigh¹, Cole, Brian J.⁴, Dahm, Diane L.⁵, Donnell-Fink, Laurel A.¹, Guermazi, Ali³, Haas, Amanda K.², Jones, Morgan H.⁶, Levy, Bruce A.⁵, Mandl, Lisa A.⁷, Martin, Scott D.¹, Marx, Robert G.⁷, Miniaci, Anthony⁶, Matava, Matthew J.^2,5, Palmisano, Joseph³, Reinke, Emily K.⁸, Richardson, Brian E.⁸, Rome, Benjamin N.¹

المصدر: New England Journal of Medicine. 5/2/2013, Vol. 368 Issue 18, p1675-1684. 10p.

مصطلحات موضوعية: *MENISCECTOMY, *MENISCUS injuries, *OSTEOARTHRITIS treatment, *PHYSICAL therapy research, *TREATMENT of arthritis, *THERAPEUTICS

مستخلص: The article focuses on a study which compared the functional outcomes of arthroscopic partial meniscectomy with nonoperative therapy in symptomatic patients with a meniscal tear and knee osteoarthritis. A total of 351 patients were randomly assigned to surgery and postoperative physical therapy or to a standardized physical therapy regimen. Results revealed no significant differences between the study groups in functional improvement 6 months after randomization.