The value of conservative treatment in improving pain and function in middle-aged patients with degenerative meniscal tears ; L’intérêt du traitement conservateur dans l’amélioration de la douleur et de la fonction chez les patients d’âge moyen atteints de déchirures méniscales dégénératives

Introduction : Degenerative meniscal tears (DMTs) are a common source of pain and functional limitation in middle-aged adults. Surgical treatment, long seen as standard, is now questioned regarding its long term effectiveness. Meanwhile, supervised exercise therapy is gaining attention. Objective : To compare the effectiveness of therapeutic exercise programs with arthroscopic partial meniscectomy (APM) in improving pain and function in middle-aged patients with DMTs. Method : Literature searches were conducted up to March 2025, mainly on PubMed, PEDro and Cochrane, according to pre-established inclusion and exclusion criteria. Data were extracted, analyzed and methodological bias was assessed using the PEDro scale. A qualitative summary in tabular form and a forest plot were produced. Results : Four RCTs were selected. A trend in favor of conservative treatment was observed for long-term pain, with no significant difference in function. However, no treatment was clearly superior. Discussion : Study heterogeneity and variable quality led to a very low level of evidence (GRADE), limiting the scope of the clinical conclusions. Conclusion : Physiotherapy is emerging as a promising alternative, but further, more standardized studies are needed to guide clinical recommendations. ; Introduction : les déchirures méniscales dégénératives (DMD) représentent une cause fréquente de douleur et de limitations fonctionnelles chez l’adulte d’âge moyen. Le traitement chirurgical, longtemps considéré comme une option de référence, voit aujourd’hui son efficacité à long terme remise en question. Parallèlement, les traitements conservateurs, notamment l’exercice thérapeutique encadré par un kinésithérapeute, suscitent un intérêt croissant. Objectif : cette revue systématique vise à comparer l’efficacité de programmes d’exercices thérapeutiques à celle de la méniscectomie partielle arthroscopique (MPA), dans l’amélioration de la douleur et de la fonction chez les patients d’âge moyen atteints de DMD. Méthode : Les recherches ...