Our Summary

This research paper is a systematic review and meta-analysis of the benefits of arthroscopic partial meniscectomy (APM), a surgical procedure to remove or fix a torn knee cartilage, in adults with a meniscal tear and knee pain. The researchers looked at three groups: all patients with any type of meniscal tear, those with a tear but without osteoarthritis (a type of joint disease), and those with an unstable tear but without osteoarthritis.

They collected and analyzed data from various sources and found 10 relevant studies. The analysis revealed that there was a small improvement in knee pain, quality of life, and knee function in the overall patient group when APM was compared to non-surgical treatment like physiotherapy. However, this improvement was not observed when APM was compared to placebo surgery.

When they narrowed down their focus to people without osteoarthritis, they found a slightly greater improvement in knee pain, quality of life, and knee function. However, no studies were found pertaining to patients with an unstable meniscal tear in a non-arthritic knee.

The conclusion was that APM should not be the first treatment option for all patients with knee pain and a meniscal tear. It may provide small to moderate benefits compared to physiotherapy for patients without osteoarthritis. However, more research is needed to understand its value in patients with an unstable meniscal tear in a non-arthritic knee.

FAQs

  1. What is arthroscopic partial meniscectomy (APM), and who is it beneficial for?
  2. What were the findings of the research in terms of improvement in knee pain, quality of life, and knee function after APM?
  3. Are there any studies available on the impact of APM on patients with an unstable meniscal tear in a non-arthritic knee?

Doctor’s Tip

A doctor might tell a patient considering meniscectomy to carefully weigh the potential benefits and risks of the procedure, and to explore non-surgical treatment options first, such as physiotherapy. They may also recommend seeking a second opinion or further discussing the procedure with a specialist to ensure it is the best course of action for their individual situation. Additionally, they may advise the patient to follow post-operative rehabilitation protocols to optimize their recovery and outcomes.

Suitable For

Overall, patients who are typically recommended for meniscectomy are those with knee pain and a meniscal tear, especially those without osteoarthritis. However, the decision to undergo surgery should be carefully considered, as the benefits of APM compared to non-surgical treatments may be small to moderate. More research is needed to determine the effectiveness of APM in patients with specific characteristics, such as an unstable meniscal tear in a non-arthritic knee.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient undergoes physical examination, imaging tests (such as MRI), and possibly non-surgical treatments like physical therapy or medication.
  3. If non-surgical treatments are not effective, the patient may be recommended for arthroscopic partial meniscectomy.

After meniscectomy:

  1. Patient undergoes the surgical procedure to remove or fix the torn meniscus.
  2. Patient goes through a recovery period that includes physical therapy to regain strength and range of motion in the knee.
  3. Patient may experience temporary pain and swelling post-surgery.
  4. Over time, patient should experience improvement in knee pain, function, and quality of life.
  5. Long-term outcomes may vary depending on the individual and the extent of the meniscal tear.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a meniscectomy procedure?
  2. What is the success rate of meniscectomy in improving knee pain and function?
  3. How long is the recovery period after a meniscectomy surgery?
  4. Are there any alternative treatments or therapies that could be considered before opting for surgery?
  5. How will the surgery affect my ability to participate in physical activities or sports in the future?
  6. Will I need physical therapy or rehabilitation after the surgery?
  7. What are the long-term implications of having a meniscectomy?
  8. How likely is it that the meniscal tear could reoccur after the surgery?
  9. What are the criteria for determining if a patient is a good candidate for a meniscectomy procedure?
  10. Are there any specific lifestyle changes or precautions I should take post-surgery to promote healing and prevent further injury?

Reference

Authors: Abram SGF, Hopewell S, Monk AP, Bayliss LE, Beard DJ, Price AJ. Journal: Br J Sports Med. 2020 Jun;54(11):652-663. doi: 10.1136/bjsports-2018-100223. Epub 2019 Feb 22. PMID: 30796103