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The Meniscal Transplant surgery or Optimised Rehabilitation - Full Randomised Trial (MeTeOR2)

Chief Investigators: Mr Andrew Metcalfe and Mr Tim Spalding

Sponsor: University of Warwick

Funder: NIHR Health Technology Assessment Programme & National Health and Medical Research Council

Registration Number: ISRCTN 87336549


The meniscus is an important structure within the knee. One of its key roles is to cushion impact and protect the gliding surface of the joint from wear. Patients that have damaged their meniscus, and had a removal of the meniscus (a total meniscectomy), are more likely to develop persistent pain after this resulting in years of disability.

At present, there are several treatment options ranging from knee therapy (physiotherapy) to a replacement meniscus also known as a 'meniscal transplant'. Meniscal transplant is thought to provide cushioning to the joint surfaces and improve symptoms but it has a long recovery period and the operation carries risk of surgery as well as not helping with symptoms. At present, there is no direct evidence that meniscal transplant is better or worse, than a specific targeted rehabilitation and therapy program.

In this study, we will compare two treatments for patients with a total meniscectomy. One group of patients will have a course of personalised knee therapy and the other group will have a meniscal transplant. In total a 144 participants will be recruited from 12 NHS Trusts and 3 international sites and followed up for 24 months post randomisation.

Sample size:

144 participants from 12 NHS Trust and internationally, in Belgium, Canada and Australia

Primary outcome:

Clinical Effectiveness: To compare the clinical effectiveness of an initial treatment strategy of MAT compared to PKT, based on participant-reported knee function at 24 months post randomisation, using the four-domain version of the Knee Injury and Osteoarthritis Score (KOOS4).
Cost Effectiveness: The primary cost-effectiveness objective is to determine the cost-effectiveness of MAT compared to PKT from an NHS and Personal, Social Service (PSS) perspective.


From: 1st June 2022
To: 30th November 2027
(note: long-term follow-up planned through to September 2035)