Our Summary

This study looked at whether a certain type of knee surgery, called arthroscopic meniscectomy (AM), increased the likelihood of needing a total knee replacement (TKR) in patients with knee osteoarthritis (OA). The researchers analyzed medical data from South Korea, comparing OA patients who had undergone AM with those who had not. They found that patients who had AM were 25% more likely to need a knee replacement within ten years of their surgery. This suggests that doctors should be cautious about recommending AM for OA patients, as it may lead to the need for more invasive surgery in the future. The study did not find a significant difference in death rates between the two groups.

FAQs

  1. What is arthroscopic meniscectomy (AM) and how does it relate to total knee replacement (TKR)?
  2. Does undergoing an arthroscopic meniscectomy increase the likelihood of needing a total knee replacement in the future?
  3. Was there any significant difference found in death rates between patients who had undergone AM and those who had not?

Doctor’s Tip

A doctor might advise a patient considering a meniscectomy to carefully weigh the potential benefits of the surgery against the risk of needing a total knee replacement in the future. They may recommend exploring non-surgical options first, such as physical therapy or pain management, to see if symptoms can be managed without surgery. It is important to have a discussion with your doctor about the potential long-term implications of a meniscectomy and to make an informed decision based on your individual circumstances.

Suitable For

Patients who are typically recommended for a meniscectomy include those with:

  1. Meniscus tears that are causing significant pain, swelling, and limited range of motion in the knee.
  2. Meniscus tears that are not responding to conservative treatments such as rest, ice, physical therapy, and medications.
  3. Meniscus tears that are causing mechanical symptoms such as locking or catching in the knee joint.
  4. Patients with a healthy knee joint and no signs of significant arthritis or degenerative changes.
  5. Younger patients with a higher likelihood of successful outcomes and quicker recovery after surgery.
  6. Patients who have tried other non-surgical treatments without success and are experiencing persistent knee pain and dysfunction.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient undergoes physical examination, imaging tests (such as MRI or X-ray), and possibly a trial of conservative treatments like physical therapy or medication.
  3. If conservative treatments are unsuccessful, the patient may be recommended for arthroscopic meniscectomy (AM) surgery.

After meniscectomy:

  1. Patient undergoes AM surgery, which involves the removal of damaged or torn meniscus tissue in the knee joint.
  2. Patient goes through a recovery period, which may include physical therapy to regain strength and flexibility in the knee.
  3. Patient gradually resumes normal activities and sports, with the goal of reducing pain and improving knee function.
  4. In some cases, patients may experience ongoing knee pain and dysfunction, leading to the need for further treatments such as total knee replacement (TKR) in the future.

What to Ask Your Doctor

  1. What is a meniscectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with a meniscectomy?
  3. How long is the recovery process after a meniscectomy?
  4. Will a meniscectomy increase my likelihood of needing a total knee replacement in the future?
  5. Are there alternative treatments or therapies that may be more appropriate for my condition?
  6. What is the success rate of meniscectomy in patients with knee osteoarthritis?
  7. How will a meniscectomy impact my daily activities and quality of life?
  8. What is the long-term outlook for my knee health if I undergo a meniscectomy?
  9. How many meniscectomy procedures have you performed and what is your success rate?
  10. Are there any lifestyle changes or exercises I should consider before or after a meniscectomy to improve my knee health?

Reference

Authors: Park CM, Ryoo S, Choi M, Lee SJ, Yoo JJ, Kim HA. Journal: J Korean Med Sci. 2023 Jan 2;38(1):e6. doi: 10.3346/jkms.2023.38.e6. PMID: 36593689