Our Summary

This research paper investigates whether surgery or exercise is more effective for treating degenerative meniscal tears in the knee over a five-year period. The researchers looked at various databases, searching for studies that compared physical therapy to a specific type of knee surgery (arthroscopic partial meniscectomy) plus exercise. They found 4 studies that fit their criteria out of 3743 articles.

The results showed that there was no significant difference between the two treatment methods when it came to pain, symptoms, activities of daily living, and quality of life. However, those who had surgery plus exercise seemed to do better in sports and recreational activities. But when they removed one study and re-analyzed the data, this difference was no longer significant.

In simple terms, the study suggests that adding this specific type of knee surgery to an exercise program doesn’t seem to provide any additional benefits in terms of knee function after five years.

FAQs

  1. What was the primary focus of the research study on degenerative meniscal tears?
  2. Did the research show any significant difference between physical therapy and arthroscopic partial meniscectomy plus exercise in treating degenerative meniscal tears?
  3. Did the study suggest any benefits of adding arthroscopic partial meniscectomy to an exercise program for knee function after five years?

Doctor’s Tip

A doctor might tell a patient considering meniscectomy that while surgery can help improve symptoms in the short term, it may not provide long-term benefits compared to physical therapy alone. It is important for patients to discuss all treatment options with their doctor and consider the potential risks and benefits before making a decision. Additionally, following a comprehensive rehabilitation program post-surgery is crucial for optimal recovery and long-term knee health.

Suitable For

Patients who are typically recommended for meniscectomy are those with symptomatic degenerative meniscal tears in the knee that have not responded to conservative treatments such as physical therapy and medications. These tears are often caused by wear and tear on the knee joint due to age or overuse, rather than a specific injury. Meniscectomy may be recommended for patients who are experiencing persistent pain, swelling, and limited range of motion in the knee that affects their daily activities and quality of life.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient may undergo physical therapy or other non-surgical treatments to manage symptoms.
  3. Patient undergoes imaging tests such as MRI to confirm diagnosis of meniscal tear.
  4. Surgeon recommends arthroscopic partial meniscectomy as treatment option.

After meniscectomy:

  1. Patient undergoes surgery to remove the damaged part of the meniscus.
  2. Patient undergoes post-operative rehabilitation including physical therapy to regain strength and range of motion in the knee.
  3. Patient experiences initial pain and swelling after surgery, which gradually decreases over time.
  4. Patient gradually returns to normal activities and sports as knee function improves.
  5. Long-term follow-up shows similar outcomes between surgery plus exercise and exercise alone, with no significant difference in pain, symptoms, and quality of life after five years.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with meniscectomy surgery?

  2. What is the success rate of meniscectomy surgery in terms of relieving pain and improving knee function?

  3. How long is the recovery time after meniscectomy surgery and what can I expect during the recovery process?

  4. Are there alternative treatment options to consider before opting for meniscectomy surgery?

  5. Will I need physical therapy or rehabilitation after surgery, and if so, what does that entail?

  6. How long do the effects of meniscectomy surgery typically last, and are there any long-term implications to consider?

  7. How soon can I return to normal activities, such as work, exercise, and sports, after meniscectomy surgery?

  8. Are there any specific exercises or lifestyle changes I should implement to help prevent future knee injuries or complications?

  9. What is the likelihood of needing additional surgeries or treatments in the future after undergoing meniscectomy surgery?

  10. Are there any specific criteria or factors that make me a better candidate for meniscectomy surgery, or are there any reasons why I may not be a suitable candidate for the procedure?

Reference

Authors: Fernández-Matías R, García-Pérez F, Gavín-González C, Martínez-Martín J, Valencia-García H, Flórez-García MT. Journal: Arch Orthop Trauma Surg. 2023 May;143(5):2609-2620. doi: 10.1007/s00402-022-04579-y. Epub 2022 Aug 22. PMID: 35996030