Our Summary

The research paper discusses the effectiveness of arthroscopic partial meniscectomy (APM), a surgical procedure that removes part of a damaged knee meniscus. The authors used a new method called “benchmarking” to evaluate the evidence from past clinical trials on APM. They compared this new method to two established methods, the Cochrane method and the CONSORT method.

They looked at seven clinical trials on APM. According to their benchmarking method, only one trial that focused on real-world effectiveness of APM recruited patients properly and showed a significant benefit from the procedure. All the trials had issues with reporting patient details and how well patients adhered to the treatments. Also, in five trials, between 19% and 36% of patients switched from non-surgical treatment to surgery.

The study suggests that APM may be effective for carefully chosen patients, or those who don’t respond to non-surgical treatment. However, the authors call for more rigorous trials that better represent the patient population and thoroughly report patient characteristics and treatment adherence.

FAQs

  1. What is arthroscopic partial meniscectomy (APM) and how was its effectiveness evaluated in this study?
  2. What is “benchmarking” and how does it compare to the Cochrane and CONSORT methods?
  3. What are the main findings from the clinical trials on APM according to the benchmarking method?

Doctor’s Tip

A helpful tip a doctor might tell a patient about meniscectomy is to carefully consider all treatment options, including non-surgical options, before opting for surgery. It is important to discuss the risks and benefits of the procedure with your healthcare provider and make an informed decision based on your individual circumstances. Additionally, following post-operative rehabilitation and physical therapy recommendations is crucial for a successful recovery after meniscectomy.

Suitable For

Patients who are typically recommended for meniscectomy are those who have a torn or damaged meniscus in the knee that is causing significant pain, swelling, and limited mobility. These patients may have tried non-surgical treatments such as physical therapy, rest, and medication, but have not experienced relief of their symptoms. It is important for patients to be carefully evaluated by a healthcare provider to determine if meniscectomy is the best course of treatment for their specific condition.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion in the affected knee.
  2. Patient undergoes physical examination, imaging tests (such as MRI), and possibly non-surgical treatments like physical therapy or medications.
  3. If non-surgical treatments are ineffective, the patient may be recommended for meniscectomy surgery.

After meniscectomy:

  1. Patient undergoes the surgical procedure to remove part of the damaged meniscus in the knee.
  2. Patient goes through a recovery period, which may include physical therapy to regain strength and range of motion in the knee.
  3. Patient gradually resumes normal activities and sports, with the possibility of experiencing improvements in knee pain and function.
  4. Long-term follow-up is necessary to monitor the success of the surgery and any potential complications or re-injuries.

What to Ask Your Doctor

  1. Can you explain the potential risks and benefits of undergoing a meniscectomy for my specific condition?

  2. How will this surgery impact my daily activities, such as work, exercise, and hobbies?

  3. Are there any alternative treatments or therapies I should consider before opting for surgery?

  4. What is the success rate of meniscectomy for patients with similar characteristics to mine?

  5. How long is the recovery process after a meniscectomy, and what can I expect in terms of pain and physical therapy?

  6. Are there any long-term implications or complications associated with undergoing a meniscectomy?

  7. What criteria do you use to determine if a patient is a suitable candidate for meniscectomy?

  8. Can you provide me with information on your experience and success rates with performing meniscectomy procedures?

  9. Will I need to make any lifestyle changes or modifications to prevent further injury or damage to my knee after the surgery?

  10. Are there any specific exercises or rehabilitation protocols I should follow post-surgery to optimize my recovery and outcomes?

Reference

Authors: Malmivaara A. Journal: Scand J Med Sci Sports. 2018 Sep;28(9):1970-1981. doi: 10.1111/sms.13215. Epub 2018 Jun 10. PMID: 29770517