Project status: Active, not recruiting.

Symptomatic knee osteoarthritis (OA) is a common, disabling problem affecting about 10% of adults over 45 years of age. Many patients with knee osteoarthritis also have tears of their meniscus. While there are no authoritative guidelines directing the care of patients with symptomatic meniscal tear, clinicians typically initially refer such patients for a physical therapy (PT) regimen focused on strengthening exercises.

However, several key questions remain about PT. How much of the efficacy of PT-based regimens can be attributed to the physiologic effects of exercise? What other factors influence PT efficacy? Do subjects have to do their exercises in clinic, or can they perform them at home just as safely and effectively? Are there other non-medical therapies, not involving exercise, that may prove equally effective? Can the observed efficacy of the exercise-based PT regimen be attributed in part to the spontaneous improvement that may occur when subjects enroll in studies during a flare in symptoms and then improve over time?

The TeMPO study (Treatment of Meniscal Problems in Osteoarthritis) aims to investigate those issues. Jeffrey N. Katz, MD, MSc, Director of the Orthopedic and Arthritis Center of Outcomes Research (OrACORe), along with a team of investigators from Brigham and Women’s Hospital (BWH), received a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) to plan and develop a large randomized controlled trial. Enrollment began at all sites in winter and spring of 2018, concluded in fall of 2022, and occurred across four clinical sites:

Brigham and Women’s Hospital (Boston, MA)

Cleveland Clinic (Cleveland, OH)

University at Buffalo (Buffalo, NY)

University of Pittsburgh (Pittsburgh, PA)

Across these four sites, TeMPO recruited and randomized 879 patients with degenerative meniscal tears in the setting of osteoarthritis to one of four physical therapy treatment arms. Subjects completed 12 weeks of their designated physical therapy protocol, as well as physical examination and testing at baseline and 3 month timepoints.

To learn more about meniscal tears, visit the American Academy of Orthopedic Surgeons meniscal tear page.