Our Summary

This study looked at the long-term effects of a specific type of knee surgery called arthroscopic meniscectomy (AM). The researchers followed up with 225 patients who had this surgery due to a torn meniscus, a common knee injury, over a period of 20 years.

The study found that 4.4% of these patients eventually needed a total knee replacement. On average, this happened about 7 years after the initial surgery.

The researchers also identified several factors that made it more likely for someone to need a knee replacement after having AM. These included being aged between 40 and 50 at the time of the initial surgery, having a misaligned knee, having the surgery on the outer part of the knee, having a more severe cartilage injury, and having the entire meniscus removed.

The study also found that female patients and those between 40 and 50 at the time of surgery, as well as those with a misaligned knee and severe cartilage damage, were more likely to have worse clinical outcomes.

In simpler terms, if you’re older, female, have a misaligned knee or severe cartilage damage at the time of a meniscus surgery, you’re more likely to have poor results and may need a total knee replacement down the line.

FAQs

  1. What is arthroscopic meniscectomy (AM) and why is it performed?
  2. What factors increase the likelihood of needing a knee replacement after undergoing arthroscopic meniscectomy?
  3. Are there any demographic or health factors that can contribute to worse clinical outcomes after a meniscus surgery?

Doctor’s Tip

Therefore, it’s important to discuss these factors with your doctor before deciding on a meniscectomy. They may recommend alternative treatments or additional precautions to minimize the risk of needing a knee replacement in the future. Additionally, following your doctor’s post-operative instructions, including physical therapy and rehabilitation exercises, can help improve your long-term outcomes and reduce the risk of complications.

Suitable For

Overall, patients who are typically recommended for meniscectomy are those with a torn meniscus, especially if they are younger (under 40), have a well-aligned knee, and do not have severe cartilage damage. Patients with these characteristics are less likely to require a total knee replacement in the future and are more likely to have better clinical outcomes following the surgery. It is important for patients to discuss their individual situation with their healthcare provider to determine the best treatment plan for their specific condition.

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 a trial of conservative treatments like physical therapy.
  3. Orthopedic surgeon recommends arthroscopic meniscectomy if conservative treatments are ineffective.

After meniscectomy:

  1. Patient undergoes arthroscopic meniscectomy surgery to remove the torn part of the meniscus.
  2. Patient undergoes post-operative rehabilitation, including physical therapy to regain strength and range of motion in the knee.
  3. Patient experiences gradual improvement in knee function and reduction in pain over the following weeks and months.
  4. Long-term follow-up shows potential risk factors for poor outcomes, including the need for total knee replacement in the future.

What to Ask Your Doctor

Some questions a patient should ask their doctor about meniscectomy include:

  1. What are the potential risks and complications associated with arthroscopic meniscectomy?
  2. How long is the recovery process after meniscectomy and what can I expect in terms of pain and mobility?
  3. Are there any alternative treatments or therapies that could be considered instead of surgery?
  4. How likely am I to need a total knee replacement in the future after having a meniscectomy?
  5. Are there any specific factors about my age, gender, knee alignment, or cartilage damage that may affect the outcome of the surgery?
  6. What can I do to minimize the risk of needing a knee replacement in the future after undergoing meniscectomy?
  7. What is the long-term prognosis for someone in my specific situation who undergoes meniscectomy?
  8. Are there any specific exercises or rehabilitation programs that can help improve my knee function and prevent further complications after surgery?
  9. How often will I need follow-up appointments and monitoring after the surgery?
  10. Are there any lifestyle changes or modifications I should consider making to protect my knee health after having a meniscectomy?

Reference

Authors: Aprato A, Sordo L, Costantino A, Sabatini L, Barberis L, Testa D, Massè A. Journal: Knee. 2021 Mar;29:49-54. doi: 10.1016/j.knee.2021.01.007. Epub 2021 Feb 5. PMID: 33550175