Our Summary

This research paper discusses various strategies for managing pain in the knee after the removal of the meniscus, a piece of cartilage that acts as a cushion between the thigh and shin bones. The absence of this cartilage often leads to early onset of knee osteoarthritis, a type of joint disease that results in the breakdown of joint cartilage and underlying bone.

Some patients experience a condition known as post-meniscectomy syndrome, which is characterized by dull, persisting pain after a brief pain-free period following meniscus removal. Unfortunately, there’s not much evidence to support non-surgical ways of managing this pain.

Several treatment options were identified, including meniscus scaffolds (which provide mid-term pain relief), meniscus allograft transplantation (a temporary solution that can also slow down the progression of osteoarthritis), isolated cartilage repair, unloading osteotomies (surgical bone reshaping), meniscus prosthesis (currently in clinical trials), and joint replacements (used in later stages of the disease).

Ultimately, the research found that post-meniscectomy syndrome and knee osteoarthritis are common after meniscus removal, and the effectiveness of different treatments depends on the specifics of the patient’s condition.

FAQs

  1. What is post-meniscectomy syndrome and how common is it after meniscus removal?
  2. What are some treatment options for managing pain after the removal of the meniscus?
  3. Can non-surgical methods effectively manage the pain resulting from meniscus removal?

Doctor’s Tip

One helpful tip a doctor might give to a patient after a meniscectomy is to follow a personalized rehabilitation plan that includes physical therapy to strengthen the muscles around the knee joint. This can help improve stability and reduce the risk of further injury or complications. Additionally, maintaining a healthy weight and avoiding high-impact activities can also help alleviate pain and prevent further damage to the knee joint. It is important for patients to communicate any persistent pain or discomfort to their healthcare provider so that they can adjust their treatment plan accordingly.

Suitable For

Patients who are typically recommended for a meniscectomy are those who have a torn meniscus that is causing significant pain, swelling, and limited mobility in the knee joint. These patients may have tried conservative treatments such as physical therapy, medications, and injections without success.

Candidates for meniscectomy may include individuals who have:

  • A meniscus tear that is causing persistent pain and swelling
  • Locking or catching of the knee joint due to a torn meniscus
  • Difficulty bearing weight on the affected knee
  • Limited range of motion in the knee joint
  • Failed conservative treatments for a torn meniscus

It is important for patients considering meniscectomy to discuss the risks and benefits of the procedure with their healthcare provider and to explore alternative treatment options if appropriate. Additionally, post-operative rehabilitation and physical therapy are often recommended to help patients recover and regain strength and function in the knee joint following surgery.

Timeline

Before the 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 conservative treatments are unsuccessful, patient undergoes meniscectomy surgery to remove the damaged portion of the meniscus.

After the meniscectomy:

  1. Patient may experience initial pain and swelling post-surgery, which gradually improves over the first few weeks.
  2. Patient undergoes physical therapy to regain strength and range of motion in the knee.
  3. Some patients may develop post-meniscectomy syndrome, experiencing persistent pain and potential early onset of knee osteoarthritis.
  4. Patient and healthcare team explore various treatment options for managing pain and potentially slowing down the progression of osteoarthritis.
  5. Depending on the severity of the condition, patient may undergo additional surgeries such as meniscus scaffolds, allograft transplantation, cartilage repair, osteotomies, meniscus prosthesis, or joint replacement.

What to Ask Your Doctor

  1. What is the likelihood of developing post-meniscectomy syndrome and knee osteoarthritis after undergoing a meniscectomy procedure?
  2. What are the potential long-term consequences of meniscus removal on the knee joint?
  3. What are the available treatment options for managing pain and slowing down the progression of knee osteoarthritis after meniscus removal?
  4. What are the risks and benefits associated with each treatment option?
  5. How soon after the meniscectomy procedure can I start physical therapy and what exercises are recommended?
  6. Are there any lifestyle changes or modifications that can help alleviate pain and improve joint function after meniscus removal?
  7. What is the expected recovery time and prognosis for returning to normal activities after a meniscectomy?
  8. Are there any alternative or experimental treatments that may be beneficial for managing pain and preventing further joint damage?
  9. How frequently should follow-up appointments be scheduled to monitor the progression of knee osteoarthritis and adjust treatment plans accordingly?
  10. Can you provide recommendations for managing pain and maintaining overall joint health in the long term after meniscus removal?

Reference

Authors: Drobnič M, Ercin E, Gamelas J, Papacostas ET, Slynarski K, Zdanowicz U, Spalding T, Verdonk P. Journal: Knee Surg Sports Traumatol Arthrosc. 2019 Jun;27(6):1817-1824. doi: 10.1007/s00167-019-05424-3. Epub 2019 Mar 11. PMID: 30859265