Our Summary

This study was done to see if certain groups of patients with knee damage (specifically, degenerative meniscus tears confirmed by MRI) might benefit from a certain type of knee surgery (arthroscopic partial meniscectomy, or APM) compared to not having surgery or having a fake surgery (sham treatment). The researchers looked at data from four previous studies that involved a total of 605 patients, who were around 55 years old on average, with a slight majority being female. They measured outcomes like knee pain, overall knee function, and quality of life related to health two years after treatment. They also tried to identify potential subgroups of patients who might benefit more from APM based on certain characteristics, like age, gender, and certain symptoms.

The results showed that the APM group had a small improvement in knee pain two years after treatment compared to the non-surgical or sham group. However, there was no difference between the two groups in terms of overall knee function and health-related quality of life. They also couldn’t find any specific group of patients who benefited more from APM.

In conclusion, the study didn’t find any specific group of patients who benefited more from APM compared to not having surgery or having a fake surgery. Because of this, the researchers recommend a cautious approach to using this type of knee surgery in patients with degenerative meniscus tears.

FAQs

  1. What was the purpose of the study on arthroscopic partial meniscectomy (APM)?
  2. What were the results of the study regarding the effectiveness of APM in comparison to non-surgical or sham treatments?
  3. Did the study find any specific group of patients who benefited more from APM?

Doctor’s Tip

A helpful tip a doctor might tell a patient about meniscectomy is that while it may provide some improvement in knee pain, it may not necessarily improve overall knee function or quality of life. It’s important to have realistic expectations about the outcome of the surgery and to discuss all treatment options with your healthcare provider before making a decision. Additionally, it’s important to follow post-operative rehabilitation protocols to maximize recovery and prevent complications.

Suitable For

Typically, patients who are recommended for meniscectomy are those with a degenerative meniscus tear confirmed by MRI, who have persistent knee pain and limited function despite conservative treatments such as physical therapy or medication. Meniscectomy may be considered for patients who have not responded well to non-surgical treatments and are experiencing significant knee pain and functional limitations. It is important for patients to discuss their individual situation with their healthcare provider to determine if meniscectomy is the best treatment option for them.

Timeline

Before the meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient may undergo diagnostic tests such as MRI to confirm a meniscus tear.
  3. Patient may try conservative treatments such as physical therapy, rest, and pain medication.
  4. If conservative treatments are not effective, the patient may be recommended for a meniscectomy.

After the meniscectomy:

  1. Patient undergoes arthroscopic partial meniscectomy surgery to remove the damaged part of the meniscus.
  2. Patient may experience post-operative pain, swelling, and stiffness.
  3. Patient undergoes physical therapy to regain strength and range of motion in the knee.
  4. Patient gradually resumes normal activities and sports, with guidance from their healthcare provider.
  5. Patient follows up with their healthcare provider for monitoring of knee function and pain relief.
  6. Research shows that there may be small improvements in knee pain after APM, but no significant difference in overall knee function and quality of life compared to non-surgical or sham treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a meniscectomy procedure?
  2. What is the expected recovery time after a meniscectomy surgery?
  3. Are there any alternative treatments or therapies that could be considered instead of surgery?
  4. Will physical therapy be necessary after the surgery, and if so, what will the rehabilitation process look like?
  5. How long can I expect the benefits of the surgery to last, and are there any long-term implications to consider?
  6. What criteria do you use to determine if a patient is a good candidate for meniscectomy surgery?
  7. How many of these procedures have you performed, and what is your success rate with this type of surgery?
  8. Are there any lifestyle changes or modifications that I should consider making after the surgery to optimize my recovery and prevent further knee damage?
  9. Are there any specific warning signs or symptoms that I should watch out for after the surgery that might indicate a complication?
  10. How often will I need to follow up with you after the surgery to monitor my progress and address any concerns?

Reference

Authors: Wijn SRW, Hannink G, Østerås H, Risberg MA, Roos EM, Hare KB, van de Graaf VA, Poolman RW, Ahn HW, Seon JK, Englund M, Rovers MM. Journal: Osteoarthritis Cartilage. 2023 May;31(5):557-566. doi: 10.1016/j.joca.2023.01.002. Epub 2023 Jan 13. PMID: 36646304