Meniscus tears in young people: surgery or not?

For young people with a meniscus tear, surgery is the treatment of choice. There were few comparative studies, until one that tackles surgery and targeted training.

Surgery vs. targeted training in young people with meniscus tears

What to do in case of a meniscus tear?

Especially for young people under 40 with a meniscus tear, surgery is often recommended as a standard procedure. The joint function in the knee is too important for this population group. But is surgery still the gold standard for such an injury? Little literature exists comparing two different treatment options. Researchers from Denmark tried to fill the gap in this.

Surgery vs. training plan for meniscus tear

The study compared the outcomes of surgery and a 12-week targeted training and exercise plan, as well as patient education. For this purpose, 63 patients between 18 and 40 years of age with a meniscus tear detected by MRI were randomised: either for surgery or for the training group. Important: all participants also complained of mechanical restrictions in the knee joint.

After three, six and twelve months, an evaluation was carried out to determine whether the knee restrictions persisted. Individual elements of the Knee Injury and Osteoarthritis Outcome Score (KOOS) were used for this purpose. The KOOS score is used to evaluate the functional status and quality of life of patients with different types of knee injuries who are at increased risk of developing osteoarthritis.2

Surgery comes out on top for meniscus tears

Of the 63 participants, 55 completed the 12-month follow-up. And although no group had perfect results, there was a clear difference: in the surgery arm, 35% of patients reported still suffering from mechanical limitations in the knee after 12 months, while this was true for 69% of participants in the training group.

The study authors emphasise, however, that although surgery for a meniscus tear leads to better results in terms of mechanical limitations in the knee, this does not apply to pain, function, and quality of life.

What treatment is preferred for a meniscus tear?

The data suggest that surgery may still be the treatment of choice for young people with a meniscal tear and limited mechanical movement. However, it is important to remember that patients who do not complain of knee joint restrictions may be more likely to benefit from a targeted exercise plan. The study shows that surgery did not lead to a more significant reduction in pain or improved quality of life.

  1. Damsted C, Thorlund JB, Hölmich P, Lind M, Varnum C, Villumsen MD, Hansen MS, Skou ST. Effect of exercise therapy versus surgery on mechanical symptoms in young patients with a meniscal tear: a secondary analysis of the DREAM trial. Br J Sports Med. 2023 May;57(9):521-527. Epub 2023 Mar 6. PMID: 36878666
  2. Knee Injury and Osteoarthritis Outcome Score (KOOS)