In Reply With regard to Dr Liebs’ concern about the indication for surgery, we would like to clarify that all patients had clinical symptoms and signs. Incidental MRI findings were actually one of the rationales for initiating this study.1 In the Netherlands, patients need a referral from their general practitioner for an orthopedic consultation. Reasons for such a referral include persistent knee pain, swelling, and other clinical symptoms. An MRI scan is performed only when a meniscal tear is suspected based on the clinical signs and symptoms. We are confident that no asymptomatic patients with incidental MRI findings participated in our trial.