Our Summary

This research examines the long-term effects and risks of a knee surgery known as arthroscopic meniscectomy, which is often performed to treat pain caused by tears in a specific part of the knee (the medial meniscal posterior root). The study looked at data from 288 patients, most of whom were female, who had the surgery between 1999 and 2010 and were followed for at least five years afterwards.

The researchers found that the surgery generally improved patients’ conditions, but many patients also showed signs of arthritis two years after the operation. They identified several factors that increased the risk of developing severe arthritis requiring another surgery (total knee arthroplasty or TKA) - these included older age, higher body mass index, a particular type of knee alignment (varus), and having a pre-existing grade of arthritis.

Patients with well-aligned knees that did not have arthritis survived significantly longer without needing another surgery compared to those with varus alignment or pre-existing arthritis. The researchers concluded that while arthroscopic meniscectomy is an effective treatment for this type of knee tear, it should be undertaken cautiously in patients with varus alignment and pre-existing arthritis.

FAQs

  1. What are the long-term effects of arthroscopic meniscectomy?
  2. What factors increase the risk of developing severe arthritis requiring another surgery after arthroscopic meniscectomy?
  3. Should patients with varus alignment and pre-existing arthritis consider arthroscopic meniscectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about meniscectomy is to follow a structured rehabilitation program to strengthen the knee muscles and improve range of motion. This can help prevent further complications and promote a successful recovery. Additionally, maintaining a healthy weight and staying active can also help reduce the risk of developing arthritis in the future. Regular follow-up appointments with a healthcare provider are important to monitor the knee’s progress and address any issues that may arise.

Suitable For

Patients who are typically recommended for arthroscopic meniscectomy are those with tears in the medial meniscal posterior root of the knee that are causing significant pain and dysfunction. These patients may have tried conservative treatments such as physical therapy and medication without success. Additionally, patients who are younger, have a lower body mass index, and do not have pre-existing arthritis or varus alignment may have better outcomes and a lower risk of developing severe arthritis requiring further surgery. It is important for healthcare providers to carefully assess each patient’s individual risk factors and discuss the potential benefits and risks of the surgery before proceeding with treatment.

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 and pain medications.
  3. After consulting with a orthopedic surgeon, patient decides to undergo arthroscopic meniscectomy surgery.

After meniscectomy:

  1. Patient undergoes the minimally invasive arthroscopic meniscectomy surgery to remove the torn part of the meniscus.
  2. Patient goes through a period of recovery, including physical therapy to regain strength and range of motion in the knee.
  3. In the long term, patient experiences relief from knee pain and improved function.
  4. However, some patients may develop arthritis in the knee in the years following the surgery, especially if they have certain risk factors like older age, higher BMI, varus alignment, or pre-existing arthritis.
  5. Patients with well-aligned knees and no pre-existing arthritis have a lower risk of developing severe arthritis and needing another surgery like total knee arthroplasty.
  6. Regular follow-up with a healthcare provider is recommended to monitor the knee’s condition and address any potential issues that may arise.

What to Ask Your Doctor

  1. What are the potential risks and complications of a meniscectomy surgery?

  2. How long is the recovery time after a meniscectomy surgery?

  3. Will I need physical therapy after the surgery, and if so, for how long?

  4. What are the long-term effects of a meniscectomy surgery, particularly in terms of arthritis development?

  5. Are there any alternative treatments or therapies that I could consider instead of surgery?

  6. Will I be able to return to my normal activities, such as sports or exercise, after the surgery?

  7. How likely am I to need additional surgeries in the future, such as a total knee arthroplasty?

  8. Are there any lifestyle changes or modifications that I should make to improve the outcome of the surgery?

  9. How experienced are you in performing meniscectomy surgeries, and what is your success rate with this procedure?

  10. Can you provide me with any patient testimonials or success stories from individuals who have undergone a meniscectomy surgery with you?

Reference

Authors: Lee BS, Bin SI, Kim JM, Park MH, Lee SM, Bae KH. Journal: Am J Sports Med. 2019 Mar;47(3):606-611. doi: 10.1177/0363546518819225. Epub 2019 Jan 23. PMID: 30673297