Our Summary

This research paper looked at whether having a previous meniscectomy (surgery to remove part or all of the meniscus in the knee) affects the results of a total knee arthroplasty (knee replacement surgery). The researchers studied patients who had both surgeries and those who only had a knee replacement, comparing their functionality after the operation.

They found that patients who had a meniscectomy before their knee replacement tended to have lower scores on a standard test of knee function after their knee replacement surgery. They were also less likely to reach the minimum score thought to represent a meaningful improvement, or a level of symptoms they found acceptable.

So, if you’ve had a meniscectomy, you might not do as well after a knee replacement as someone who hasn’t had that surgery. This information can be used to manage patients’ expectations before they have a knee replacement.

FAQs

  1. Does having a previous meniscectomy affect the results of a total knee arthroplasty?
  2. How does a previous meniscectomy impact knee functionality after a knee replacement surgery?
  3. How can this information about the impact of a previous meniscectomy on knee replacement surgery outcomes be used in patient care?

Doctor’s Tip

One helpful tip a doctor might tell a patient about meniscectomy is to try to preserve as much of the meniscus as possible during the surgery. The meniscus plays an important role in cushioning and stabilizing the knee joint, so the more of it that can be preserved, the better the long-term outcomes may be. Additionally, patients should follow their post-operative rehabilitation plan closely to ensure optimal recovery and function.

Suitable For

Patients who are typically recommended for a meniscectomy are those who have a torn meniscus in the knee that is causing significant pain, swelling, and limited range of motion. Meniscectomies are commonly performed in patients with meniscus tears that do not respond to conservative treatments such as rest, physical therapy, and anti-inflammatory medications. Meniscectomies are also recommended for patients with a meniscus tear that is causing mechanical symptoms such as locking or catching in the knee joint.

Other factors that may influence the recommendation for a meniscectomy include the size and location of the meniscus tear, the patient’s age, activity level, and overall health. In some cases, a meniscectomy may be recommended as part of a larger surgical procedure, such as a knee ligament reconstruction or knee replacement surgery.

Overall, patients who are recommended for a meniscectomy are those who have persistent and debilitating symptoms related to a meniscus tear that have not improved with conservative treatments. It is important for patients to discuss their treatment options with their healthcare provider to determine the best course of action for their individual situation.

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 conservative treatments like physical therapy or corticosteroid injections.
  3. If symptoms persist, patient may be recommended for a meniscectomy surgery.

After meniscectomy:

  1. Patient undergoes meniscectomy surgery to remove part or all of the damaged meniscus.
  2. Patient goes through a period of recovery, including physical therapy to regain strength and range of motion in the knee.
  3. Patient may experience temporary pain and swelling post-surgery.
  4. Patient gradually resumes normal activities, with improvements in knee function over time.

Before knee replacement:

  1. Patient experiences worsening knee pain, stiffness, and difficulty walking.
  2. Patient undergoes physical examination, imaging tests, and conservative treatments like pain medications or assistive devices.
  3. If symptoms continue to interfere with daily activities, patient may be recommended for a knee replacement surgery.

After knee replacement:

  1. Patient undergoes knee replacement surgery to replace the damaged knee joint with an artificial implant.
  2. Patient goes through a period of recovery, including physical therapy to rebuild strength and mobility in the knee.
  3. Patient may experience temporary pain and swelling post-surgery.
  4. Patient gradually resumes normal activities, with significant improvements in knee function and pain relief.

What to Ask Your Doctor

Some questions a patient should ask their doctor about meniscectomy in relation to knee replacement surgery may include:

  1. How does a previous meniscectomy affect the outcome of a knee replacement surgery?
  2. What are the potential risks or complications of having a knee replacement after a meniscectomy?
  3. Will I need a different type of knee replacement surgery if I’ve had a meniscectomy?
  4. What can I do to improve my chances of a successful outcome after a knee replacement if I’ve had a meniscectomy?
  5. Are there any specific rehabilitation or physical therapy exercises I should focus on if I’ve had a meniscectomy before my knee replacement surgery?
  6. How long should I expect the recovery process to take if I’ve had a meniscectomy before my knee replacement surgery?
  7. Are there any alternative treatment options to consider instead of knee replacement if I’ve had a meniscectomy?
  8. Will I need additional follow-up care or monitoring after a knee replacement if I’ve had a meniscectomy?
  9. Can you provide me with more information or resources on the potential impact of a previous meniscectomy on knee replacement surgery outcomes?

Reference

Authors: Khan IA, DeSimone CA, Sonnier JH, Vaile JR, Mazur DW, Freedman KB, Fillingham YA. Journal: J Arthroplasty. 2023 Jul;38(7 Suppl 2):S187-S193. doi: 10.1016/j.arth.2023.01.062. Epub 2023 Feb 9. PMID: 36764401