A new 5-year follow-up study for the FIDELITY trial has just been publishedin Osteoarthritis and Cartilage, addinganother important piece to the puzzle in the ongoing debate about theeffectiveness and potential harms of arthroscopic partial meniscectomy.
The publication, titled "Effect of arthroscopic partial meniscectomy on structural degeneration of the knee – A 5-year MRI-based follow-up of the placebo-surgery controlled FIDELITY trial", is the first placebo-controlled trial with 5-year MRI-based assessment of knee structural changes following APM, with high follow-up retention, setting it apart methodologically from previous RCTs. It reveals that patients undergoing APM may experiences lightly greater structural degeneration of the knee over time, particularly the formation of osteophytes, compared to those who received placebo surgery.
While earlier results from the FIDELITY trial showed no relevant difference in patient-reported outcomes between groups, thisMRI-based analysis gives deeper insight into what might be happening under the surface, even when the knee “feels” the same.
Key findings:
- Osteophyte progression was significantly more common in the APM group.
- Cartilage and bone marrow lesions also showed more frequent progression in the APM group, though the differences were more subtle.
- The study confirms a consistent pattern seen across multiple trials: less may be more when it comes to surgery for degenerative meniscus tears.
This study further emphasizes the importance of high-quality, blinded, placebo-controlled trials, especially in surgical research where assumptions can persist for decades without strong evidence.
Read the full open-access article HERE
Read more about the FIDELITY trial HERE
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