Our Summary

This research paper analyses the effects of a type of knee surgery (Arthroscopic Partial Meniscectomy or APM) on patients who are 30 years or older and have a specific type of knee injury (degenerative meniscal tear) that has not responded to non-surgical treatments.

The study used a questionnaire called the Knee Injury and Osteoarthritis Outcome Score (KOOS) to measure the patients’ knee problems before and 1 year after the surgery. The questionnaire includes 42 questions about different aspects of knee function and symptoms, each rated from 0 (extreme problems) to 4 (no problems).

The analysis found that after the surgery, patients reported the most improvement in their awareness of knee problems, frequency of knee pain, difficulty while twisting or pivoting on the injured knee, difficulty while running, and lack of confidence in the knee. They reported the least improvement in difficulty getting on and off the toilet, feeling grinding or hearing clicking when the knee moves, difficulty getting in and out of the bath, the knee catching or hanging up during movement, and the ability to fully straighten the knee.

The study also found that the surgery was more effective in improving symptoms related to the meniscus (a piece of cartilage that provides a cushion between the thigh bone and shin bone) than mechanical symptoms (those related to the physical function of the knee joint). This suggests that focusing on meniscal rather than mechanical symptoms could help surgeons identify patients who are most likely to benefit from this type of surgery.

FAQs

  1. What is Arthroscopic Partial Meniscectomy (APM) and who is it most beneficial for?
  2. How is the effectiveness of APM surgery measured in this study?
  3. What symptoms showed the most and least improvement after APM surgery, according to this study?

Doctor’s Tip

One tip a doctor might give a patient about meniscectomy is to follow a structured rehabilitation program after the surgery to help regain strength and range of motion in the knee. This may include physical therapy exercises, icing the knee, and avoiding high-impact activities until cleared by the doctor. It is important to listen to your body and not push yourself too hard during the recovery process to prevent further injury. Additionally, maintaining a healthy weight and staying active can help support the healing process and prevent future knee problems.

Suitable For

Overall, patients who are typically recommended for a meniscectomy are those who are 30 years or older, have a degenerative meniscal tear that has not responded to non-surgical treatments, and are experiencing symptoms related to the meniscus rather than mechanical symptoms. These patients may benefit from the surgery in terms of improved awareness of knee problems, reduced knee pain, and improved function in activities such as twisting, running, and feeling confident in the knee. However, it is important for surgeons to carefully evaluate each patient’s individual circumstances and symptoms to determine the best course of treatment.

Timeline

Before the meniscectomy:

  • Patient experiences knee pain, swelling, and limited range of motion
  • Patient undergoes non-surgical treatments such as physical therapy, rest, and medication
  • Symptoms persist and do not improve with conservative treatments
  • Patient and healthcare provider decide to proceed with Arthroscopic Partial Meniscectomy (APM)

After the meniscectomy:

  • Patient undergoes surgery to remove damaged portion of the meniscus
  • Patient experiences initial post-operative pain and swelling
  • Patient undergoes rehabilitation and physical therapy to regain strength and function in the knee
  • Patient gradually resumes normal activities and exercise
  • Patient completes the KOOS questionnaire before and 1 year after the surgery to evaluate improvements in knee function and symptoms
  • Patient reports improvements in certain aspects of knee function and symptoms, with varying degrees of improvement in different areas
  • Study findings suggest that the surgery is more effective in improving symptoms related to the meniscus compared to mechanical symptoms
  • Patient may experience long-term benefits from the surgery in terms of reduced pain and improved knee function.

What to Ask Your Doctor

  1. What is a meniscectomy and how is it performed?
  2. What are the potential risks and complications associated with a meniscectomy?
  3. What are the expected outcomes and recovery time following a meniscectomy?
  4. How will the surgery affect my daily activities and exercise routine?
  5. Are there any alternative treatments to a meniscectomy that I should consider?
  6. How can I prepare for the surgery and what should I expect during the recovery process?
  7. How long will it take for me to return to normal activities and sports after the surgery?
  8. Will I need physical therapy or rehabilitation after the surgery?
  9. Are there any long-term effects or considerations I should be aware of after a meniscectomy?
  10. How will the surgery impact any existing knee conditions or arthritis in the future?

Reference

Authors: Bisson LJ, Kluczynski MA, Wind WM, Fineberg MS, Bernas GA, Rauh MA, Marzo JM, Zhou Z, Zhao J. Journal: Arthroscopy. 2022 Feb;38(2):489-497.e17. doi: 10.1016/j.arthro.2021.09.029. Epub 2021 Oct 6. PMID: 34624500