Our Summary

The researchers conducted a detailed review and analysis of multiple studies to evaluate the effectiveness of a specific knee surgery, called arthroscopic partial meniscectomy (APM), on treating a type of knee injury known as degenerative meniscal tear (DMT). These tears typically happen in knees with mild or no osteoarthritis. The researchers compared the results of APM with other treatment methods, such as physical therapy and placebo surgeries (sham operations). They found that APM did not significantly improve the patients’ ability to perform daily activities or reduce their pain, compared to the other treatments. Therefore, the study suggests that APM might not be the best treatment option for patients with a DMT in knees with mild or no osteoarthritis.

FAQs

  1. What is arthroscopic partial meniscectomy (APM)?
  2. How does the effectiveness of APM compare to other treatments for degenerative meniscal tear (DMT)?
  3. Is APM recommended for patients with a DMT in knees with mild or no osteoarthritis?

Doctor’s Tip

A doctor might advise a patient undergoing meniscectomy to follow the post-operative rehabilitation plan carefully, including physical therapy exercises to strengthen the knee and improve range of motion. It is important to follow the doctor’s instructions on weight-bearing restrictions and gradually increase activity levels to avoid re-injury. Additionally, maintaining a healthy weight and avoiding high-impact activities can help prevent further damage to the knee joint.

Suitable For

Patients who are typically recommended for a meniscectomy are those with a traumatic meniscal tear that is causing significant pain, swelling, and limited range of motion in the knee. These tears are often the result of a sports injury or other trauma to the knee. Meniscectomy may also be recommended for patients with a degenerative meniscal tear that is causing persistent symptoms and has not responded to conservative treatments such as physical therapy or anti-inflammatory medications. Additionally, patients with complex tears or tears that are causing mechanical symptoms such as locking or catching in the knee may also be candidates for a meniscectomy. It is important for patients to discuss their individual symptoms and treatment options with a healthcare provider to determine if a meniscectomy is the best course of action for their specific condition.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and difficulty moving the knee joint.
  2. Patient undergoes a physical examination and imaging tests (such as MRI) to diagnose the meniscal tear.
  3. Patient may undergo conservative treatments like rest, ice, physical therapy, and pain medications to manage symptoms.
  4. If conservative treatments do not provide relief, the patient may be recommended for arthroscopic partial meniscectomy (APM) surgery.

After meniscectomy:

  1. Patient undergoes APM surgery to remove the damaged portion of the meniscus.
  2. Patient undergoes a period of post-operative rehabilitation and physical therapy to regain strength and range of motion in the knee.
  3. Patient may experience pain, swelling, and stiffness in the knee immediately after surgery.
  4. Over time, the patient gradually resumes normal activities and experiences reduced pain and improved knee function.
  5. Patient may need to continue with physical therapy and rehabilitation exercises to fully recover and prevent future knee injuries.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a meniscectomy procedure?
  2. How long is the recovery time after a meniscectomy surgery?
  3. What are the chances of the meniscus tearing again after the surgery?
  4. Are there any alternative treatments or therapies that could be considered instead of a meniscectomy?
  5. How soon after the surgery can I return to my normal activities, such as sports or exercise?
  6. Will physical therapy be necessary after the surgery, and if so, for how long?
  7. What type of post-operative pain management options are available?
  8. How likely is it that the meniscectomy will alleviate my knee pain and improve my mobility?
  9. Are there any long-term effects or complications that I should be aware of after the surgery?
  10. Will I need to follow any specific precautions or restrictions during the healing process?

Reference

Authors: Lee SH, Lee OS, Kim ST, Lee YS. Journal: Clin J Sport Med. 2020 May;30(3):195-202. doi: 10.1097/JSM.0000000000000585. PMID: 29995671