Meniscal tear outcome study (METRO)

The meniscus is a cartilage based structure in the knee. Meniscal tears are very common and can occur following an injury or can happen without a specific cause. Sometimes they happen because there is some arthritis in the knee, but sometimes they happen in an otherwise normal knee. They may be painful, cause swelling or clicking in the knee, or sometimes cause the knee to catch or stick. A meniscal tear is most commonly diagnosed with a magnetic resonance imaging (MRI) scan.

Meniscal tears can be treated with keyhole surgery, physiotherapy, pain relief or sometimes they get better on there own. Previous research has shown that physiotherapy is as effective as surgery in patients with meniscal tears. However, the majority of patients in these studies also had knee arthritis which could have been the cause of the pain rather than the meniscal tear.

The purpose of this study is find out what is the current management of young patients (patients under 55) with meniscal tears in the population and what happens to these patients. We want to find out about the pain, stiffness or other problems you may have with your knee over the next year. We will work out how many people have signs of arthritis in their knee on their scans, and whether there are particular symptoms, or findings on the scan, that affect the success of treatment. We will use this information to improve the way we care for people with tears of the meniscus in the future.

To do this we plan on recruiting patients when they present to hospital following an MRI diagnosis of a meniscal tear. We will not influence the treatment decision of the treating clinician. We will then collect baseline information with a questionnaire and we will also review the MRI scan using novel techniques in analysis of bone shape. Patients will then be asked to complete questionnaires at 3,6 and 12 months.

We will also interview a small subset of the patients (METRO Interview study) in order to the patients experience of living with a meniscal tear and how it impacts their quality of life.

At the end of this study we will have a clearer understanding of the current management of young patients with a meniscal tear, their experiences of their management

200 for the METRO study

20 for the METRO interview study

Inclusion criteria:

• Presence of a MRI confirmed meniscal tear
• Age between 18-55

Exclusion criteria:

• ACL or other major knee ligament injury. This does not include previous unrelated healed MCL tear or a meniscal root tear (which is considered a type of meniscal tear in this study)
• Associated intra-articular fracture of the tibial plateau or femur. Previous fractures not thought to be related to the tear are not an exclusion criteria for the study.
• Previous knee surgery
• Previous entry into the present study (i.e the other knee)
• Unable to undertake study procedures

Western Ontario Meniscal Evaluation Tool (WOMET) score at 12 months.

3 years.

(6 months set up, 12 months recruitment, 12 months follow up and 6 months analysis and dissemination)

metro@warwick.ac.uk