{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:56:11Z","timestamp":1789545371783,"version":"build-2803163510"},"reference-count":31,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"3","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p> OBJECTIVE: To investigate whether magnetic resonance imaging (MRI) findings modified the outcomes of early surgery compared to exercise and education in young patients with meniscal tears. <\/jats:p><jats:p> DESIGN: A secondary effect modifier analysis of a randomized controlled trial. <\/jats:p><jats:p> METHODS: The primary outcome was change from baseline to 12 months in the mean score of 4 Knee injury and Osteoarthritis Outcome Score subscales (KOOS<jats:sub>4<\/jats:sub>). Three potential MRI-defined effect modifiers were predefined: (1) the type of meniscal tear (simple vs bucket handle or complex), (2) the meniscus affected (medial vs lateral), and (3) the presence of knee effusion\/synovitis (yes\/no). We used a linear mixed model to investigate the difference in mean change between the treatment groups, stratified by each of the 3 potential effect modifiers, and estimated the interactions. An adjusted effect difference \u2265 10 points (0-100 scale) was considered clinically relevant. <\/jats:p><jats:p> RESULTS: Data from all participants (60 in the surgery group and 61 in the exercise group) were analyzed. The mean (SD) age was 29.7 (6.6) years, and 28% were female. A potential effect modification was observed for knee effusion\/synovitis, with its presence implying an increase of the effect of early surgery by 11 points on the KOOS<jats:sub>4<\/jats:sub> ( P = .07). <\/jats:p><jats:p> CONCLUSION: Knee effusion\/synovitis on MRI potentially modified the treatment effect with a clinically relevant difference in change of the KOOS<jats:sub>4<\/jats:sub> in patients with effusion\/synovitis, favoring early surgery. We found no indication that patients with bucket handle or complex versus simple tears or medial versus lateral tears benefited more from early surgery. J Orthop Sports Phys Ther 2025;55(3):218-228. 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