The University of Warwick is recruiting participants for two clinical trials to help people who have injured their knees through dislocations and tears.

Warwick Medical School is leading two revolutionary trials to compare the treatment benefits of traditional physiotherapy rehabilitation with transplanted knee surgeries.

The researchers hope the trials will help to understand what treatment options are best for knee dislocations and tears, which can devastate the lives of anyone; particularly those who engage in sports and a high level of exercise.

METEOR2 will look at the treatment benefits for those with meniscus tears. REPPORT will be for those with patella dislocations. Both trials are funded by the National Institute for Health and Care Research (NIHR).

Professor Toby Smith, Clinical Trials Unit, University of Warwick, who is leading REPPORT, said: “People who have repeated knee cap (patellar) dislocations experience long term disability. This can impact their abilities to work, their education and involvement in sports or physical activities. Repeated knee cap dislocation may also lead to knee osteoarthritis in later life.

“REPPORT is for people who have had two or more knee cap dislocations. We will be comparing how well people recovery from this persistent problem after a course of physiotherapy or after having an operation. The results of this trial will mean that in future, orthopaedic surgeons, physiotherapists and other health professionals will have research to decide whether physiotherapy or an operation is the best treatment.”

Surgeon Professor Andy Metcalfe, Clinical Trials Unit, University of Warwick, heading up the METEOR2 trial, added: “Many people have had the meniscus cartilage, which acts like a shock absorber, removed from their knee. Around 100,000 of these operations happen every year. Many get better, but a small number of people have pain as bad or worse than before. These people are often young and can be very limited by this condition.

“For some people it may be appropriate to have an operation, to insert a transplant meniscus cartilage, but we don’t know if this is better or not then a good programme of physiotherapy personalised to the individual. A transplant operation is expensive and a big thing for someone to go to, so we need to know if it helps.”

Case study – Patrick Wilson, 26, from Teesside

Patrick Wilson competed at a high level of athletics – specialising in track and field, 5km races. He was forced to give up his dream of running as career due to knee injuries which got so severe he struggled to walk 100 metres – and was told he would need a walking stick by the age of 30.

Patrick said: “I first developed a large meniscal tear in my left knee, which was treated with surgery. Then, my right knee started hurting – I ended up with the same injury in both knees. 50% of my menisci were removed.

“Having already given up my dream of running as a career my job in oil and gas was now in jeopardy too – something I’d done since training as an apprenticeship. I could barely walk and had to walk downstairs backwards. I was told I would need to live a sedentary life and my knees would only get worse.

“I couldn’t accept this or lose my livelihood, so I contacted surgeon Tim Spalding, who advised me to follow a nutrition plan and introduced me to the idea of a meniscal transplant.

“I went ahead with the transplant in December 2020 and was amazed – just six weeks afterwards the pain had just gone. Now I’m back cycling hundreds of miles every week, climbing mountains, in the gym daily and running. I want to climb Everest one day.

“The transplant was the single best decision I ever made and I want it to be available to others; I wouldn’t want anyone going through what I did at such a young age. The clinicians are giving people their lives back and changed the whole trajectory of my life.”

To find out more about the trials, go to https://warwick.ac.uk/fac/sci/med/research/ctu/trials/meteor2/ for METEOR2 and https://warwick.ac.uk/fac/sci/med/research/ctu/trials/repport/ for REPPORT.

Notes to Editors

REPPORT

In total, REPPORT plans to involve 276 people from across the UK based in 16 to 20 hospitals. The team will monitor how well people recovery and the costs associated with each treatment option over a 24-month period.

METEOR2

The METEOR2 trial is an international randomised controlled trial lead from the University of Warwick and the University Hospitals Coventry and Warwickshire and the University of Sydney. It is being funded by the NIHR in the UK and the National Health and Medical Research Council (NHMRC) in Australia. People will also participate in Canada and Belgium.

It is for people who have pain more than 6 months after meniscectomy, but do not have arthritis in their knee. In this trial, we will be comparing how well people recovery from this persistent problem after a course of physiotherapy or after having an operation. In total, we plan to involve 144 people from around 12 hospitals across the UK, as well as Australia, Canada and Belgium. We will monitor how well people recover and the costs associated with each treatment option over a 24-month period. The results of this trial will mean that in future, orthopaedic surgeons, physiotherapists and other health professionals will have research to decide whether physiotherapy or an operation is the best treatment for people with pain after a previous removal of meniscal cartilage.

Media contact

University of Warwick press office contact:

Annie Slinn 07876876934

Communications Officer | Press & Media Relations | University of Warwick Email: annie.slinn@warwick.ac.uk

About the National Institute for Health and Care Research (NIHR)

● The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

● Funding high quality, timely research that benefits the NHS, public health and social care;

● Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;

● Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;

● Attracting, training and supporting the best researchers to tackle complex health and social care challenges;

● Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;

● Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low-and-middle-income countries is principally funded through UK Aid from the UK government.


12 January 2024