Our Summary

This research study was conducted to see if a certain type of knee surgery (arthroscopic partial meniscectomy or APM) is better than a placebo (fake) surgery for treating patients with a specific type of knee issue (degenerative tear of the medial meniscus). The study involved 146 adults aged between 35 and 65 who had knee symptoms consistent with this type of tear, but who did not have knee osteoarthritis. They were randomly assigned to either receive the real surgery or the placebo surgery.

The researchers looked at various outcomes, including changes in knee scores and pain levels, and other factors such as the participant’s satisfaction and return to normal activities. They also monitored for any serious side effects.

The results showed that there were no significant differences between the two groups in any of the outcomes measured. In other words, the real surgery was not better than the placebo surgery. The study also found no evidence to suggest that patients with certain symptoms or characteristics or those who had not responded to initial non-surgical treatment would benefit more from the real surgery.

FAQs

  1. What was the purpose of this research study on arthroscopic partial meniscectomy (APM)?
  2. What were the main findings of the research study on APM and placebo surgeries?
  3. Did the study find any groups of patients who might benefit more from real arthroscopic partial meniscectomy surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about meniscectomy is to consider non-surgical options first, such as physical therapy or anti-inflammatory medications, before opting for surgery. This study suggests that in some cases, surgery may not offer additional benefits compared to conservative treatments. It’s important to discuss all treatment options with your healthcare provider to determine the best course of action for your specific situation.

Suitable For

Based on the results of this study, it can be concluded that meniscectomy is not typically recommended for patients with degenerative tears of the medial meniscus who do not have knee osteoarthritis. This suggests that other treatment options, such as physical therapy, medication, or lifestyle modifications, may be more appropriate for these patients. Meniscectomy may still be recommended for patients with other types of meniscus tears, such as traumatic tears, or for those who do not respond to conservative treatments. It is important for patients to consult with their healthcare provider to determine the best treatment option for their specific condition.

Timeline

Before the meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient undergoes initial evaluation by a healthcare provider, which may include imaging tests like an MRI to diagnose the meniscal tear.
  3. Patient may try conservative treatments such as physical therapy, pain medication, and rest to alleviate symptoms.
  4. If conservative treatments are not effective, the patient may be recommended for surgery like arthroscopic partial meniscectomy.

After the meniscectomy:

  1. Patient undergoes the surgical procedure to remove the damaged part of the meniscus.
  2. Patient goes through a period of post-operative recovery, which may include physical therapy to regain strength and range of motion in the knee.
  3. Patient gradually resumes normal activities and sports, with the guidance of their healthcare provider.
  4. Patient follows up with their healthcare provider for monitoring of their knee function and any potential complications.
  5. Research studies like the one mentioned above may provide additional insight into the effectiveness of the surgery and help guide future treatment decisions for patients with meniscal tears.

What to Ask Your Doctor

  1. What is a meniscectomy and how is it performed?
  2. What are the risks and potential complications associated with a meniscectomy surgery?
  3. How long is the recovery period after a meniscectomy surgery?
  4. What alternative treatments are available for a degenerative tear of the medial meniscus?
  5. How likely is it that the surgery will improve my symptoms and quality of life?
  6. Are there any specific criteria or factors that would make me a good candidate for a meniscectomy surgery?
  7. What should I expect in terms of pain management after the surgery?
  8. How often do patients experience a recurrence of symptoms after a meniscectomy surgery?
  9. Are there any specific post-operative exercises or physical therapy that I should be doing to aid in my recovery?
  10. Are there any long-term implications or considerations I should be aware of after having a meniscectomy surgery?

Reference

Authors: Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Ikonen A, Järvelä T, Järvinen TAH, Kanto K, Karhunen J, Knifsund J, Kröger H, Kääriäinen T, Lehtinen J, Nyrhinen J, Paloneva J, Päiväniemi O, Raivio M, Sahlman J, Sarvilinna R, Tukiainen S, Välimäki VV, Äärimaa V, Toivonen P, Järvinen TLN; FIDELITY (Finnish Degenerative Meniscal Lesion Study) Investigators. Journal: Ann Rheum Dis. 2018 Feb;77(2):188-195. doi: 10.1136/annrheumdis-2017-211172. Epub 2017 May 18. PMID: 28522452