This trial compared surgery with physical therapy (followed by surgery as needed) in patients with a meniscal tear and mild-to-moderate knee osteoarthritis. Functional outcomes and pain were similar in the two groups at 6 months; 30% of the PT group crossed over to surgery. Symptomatic, radiographically confirmed osteoarthritis of the knee affects more than 9 million people in the United States. 1 Meniscal tears are also highly prevalent, with imaging evidence of a meniscal tear observed in 35% of persons older than 50 years of age; two thirds of these tears are asymptomatic. 2 Meniscal damage is especially prevalent among persons with osteoarthritis 3 , 4 and is frequently treated surgically with arthroscopic partial meniscectomy. This procedure, in which the surgeon trims the torn meniscus back to a stable rim, is performed for a range of indications in more than 465,000 persons annually in the United States. 5 The . . .