From studying history at Middlebury college to pursuing medicine post-undergrad, rheumatologist Dr. Gregory McDermott’s unconventional…
This is the final piece of a two-part series on the history and continuation of the MeTeOR (Meniscal Tear in Osteoarthritis Research) trial. In this installment, we spoke with OrACORe directors Jeffrey Katz, MD, Msc and Elena Losina, PhD about their expectations for MeTeOR’s 12-year follow up, which set to begin in the spring of 2021.
In the first installment of this two-part story, we learned about the origins of the MeTeOR trial and the early and five-year findings. In sum, the outcomes of surgery and physical therapy were similar, but surgically treated participants experienced greater progression of cartilage damage and of bone spurs than subjects treated nonoperatively. Also, surgically treated participants were more likely to undergo total knee replacement. Whether the structural deterioration seen early on in the surgical arm continued to progress, and whether these changes were associated with worsening of pain and more total joint replacements remains to be seen. “We’re intrigued to know whether these early changes in structure influence pain and function 12 years later,” said Dr. Katz.
These unanswered questions prompted the application for the third and current MeTeOR grant in 2019. Finding potential links between what was captured on a participant’s five-year follow-up MRI and how they present clinically today could help to answer these key questions. In the 12-year follow-up study, subjects will complete questionnaires that ask about their knee symptoms, functional status, and whether they have had a knee replacement. They will also have radiographs and MRI scans so that the team can assess the progression of joint damage from five to 12 years. Finally, subjects will perform several tests that assess their muscle strength, balance, and endurance. Study visits are slated to begin in spring 2021.
MeTeOR Investigators look forward to evaluating how participants in both treatment arms are doing clinically and structurally, and whether the initial structural damage observed in the APM group has remained stable or has continued to progress. Dr. Losina commented that she is hoping the 12-year follow up can answer “the million dollar question of whether the short-term benefits of APM are outweighed by the long-term greater deterioration of knee structure.”
Additionally, the five-year follow up provided some early indication that those who underwent meniscal surgery (APM) may be more likely to have their knee replaced. The 12-year follow-up will allow investigators to evaluate whether having APM increases the likelihood of having a total knee replacement in the future.
Dr. Katz says that, in addition to trying to improve the treatment of patients with meniscal tear, one of the most rewarding aspects of MeTeOR has been working with this research team. “The MeTeOR investigators are dedicated and passionate. Over the years, we have met in early mornings and in the late evening and have had impassioned discussions about what our data mean for clinical practice. The MeTeOR investigators are academic leaders in their fields; they know these data are influential and they don’t want the message to become oversimplified because they care for MeTeOR-like patients every day. The team has enjoyed making friendships that have been rich and sustained and learning from each other. Our discussions sometimes get heated because we really care about getting the story right so that patients around the globe with knee pain, OA and meniscal tear get the best treatments.”
Read more about the science behind MeTeOR and find past publications here.