Stensrud Silje, Risberg May Arna, Roos Ewa M
From the Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark (SS, EMR); and Norwegian Research Center for Active Rehabilitation, Department of Orthopedic Surgery, Oslo University Hospital, and Norwegian School of Sport Sciences, Oslo, Norway (MAR).
Am J Phys Med Rehabil. 2015 Jun;94(6):460-73. doi: 10.1097/PHM.0000000000000209.
The aim of this study was to compare the effect of a 12-wk exercise therapy program and arthroscopic partial meniscectomy on knee strength and functional performance in middle-aged patients with degenerative meniscus tears.
A total of 82 patients (mean age, 49 yrs; 35% women) with a symptomatic, unilateral, magnetic resonance imaging-verified degenerative meniscus tear and no or mild radiographic osteoarthritis were randomly assigned to a supervised neuromuscular and strength exercise program or arthroscopic partial meniscectomy. Outcomes assessed 3 mos after intervention initiation were isokinetic knee muscle strength, lower extremity performance, and self-reported global rating of change.
Mean difference in isokinetic knee extension peak torque between the two groups was 16% (95% confidence interval, 7.1-24.0) (P < 0.0001), favoring the exercise group. Patients in the exercise group improved isokinetic knee extension peak by a mean of 25 Nm (range, 18-33 Nm) from baseline to follow-up. Furthermore, patients assigned to exercise therapy showed statistically significant improvements (P ≤ 0.002) in all other measured variables, with moderate to large effect sizes (0.5-1.3). Patients reported a similar and positive effect of both interventions.
A 12-wk supervised exercise therapy program yielded clinically relevant and statistically significant improvement in isokinetic quadriceps strength immediately after completion of the program, as compared with treatment with arthroscopic partial meniscectomy.
本研究旨在比较为期12周的运动疗法方案和关节镜下半月板部分切除术对中年退行性半月板撕裂患者膝关节力量和功能表现的影响。
共有82例患者（平均年龄49岁；35%为女性），有症状的单侧经磁共振成像证实的退行性半月板撕裂，且无或有轻度影像学骨关节炎，被随机分配至有监督的神经肌肉和力量训练方案组或关节镜下半月板部分切除术组。干预开始3个月后评估的结果包括等速膝关节肌肉力量、下肢功能表现以及自我报告的整体变化评分。
两组之间等速膝关节伸展峰值扭矩的平均差异为16%（95%置信区间，7.1 - 24.0）（P < 0.0001），运动疗法组更具优势。运动疗法组患者从基线到随访时等速膝关节伸展峰值平均提高了25牛米（范围为18 - 33牛米）。此外，接受运动疗法的患者在所有其他测量变量上均有统计学意义的改善（P ≤ 0.002），效应大小为中等至较大（0.5 - 1.3）。患者报告两种干预措施都有相似且积极的效果。
与关节镜下半月板部分切除术相比，为期12周的有监督运动疗法方案在方案完成后立即对等速股四头肌力量产生了具有临床意义且在统计学上有显著意义的改善。
