Our Summary

This research paper is a review of existing studies on two types of treatments for injuries to the meniscus, a piece of cartilage in the knee. The two treatments are meniscectomy (removal of the damaged part of the meniscus) and meniscal repair (fixing the damaged part). The review specifically looks at how often osteoarthritis (a joint disease causing pain and stiffness) develops after these treatments, how well the knee functions after treatment, and what factors influence the choice of treatment.

The researchers looked at six studies including 298 patients. They found that meniscal repair was associated with a lower rate of osteoarthritis development than meniscectomy. About half of the patients who had a meniscectomy developed osteoarthritis, compared to about a fifth of those who had a repair. The repair group also had better knee function and quality of life scores. In one study, over 70% of the repair group had complete healing, suggesting that preserving the meniscus can lead to better outcomes.

However, the researchers caution that these results should be carefully considered due to differences in the studies reviewed. Nevertheless, the findings strongly suggest that meniscal repair should be the preferred treatment for these types of injuries, emphasizing the need for a shift in clinical practice to focus on preserving the meniscus to get the best patient outcomes.

FAQs

  1. What are the two types of treatments for injuries to the meniscus?
  2. How often does osteoarthritis develop after meniscal repair and meniscectomy?
  3. What factors influence the choice between meniscectomy and meniscal repair?

Doctor’s Tip

A doctor might tell a patient that meniscal repair is a preferred treatment option for meniscus injuries, as it is associated with a lower rate of osteoarthritis development and better knee function compared to meniscectomy. It is important to preserve the meniscus whenever possible to achieve the best outcomes.

Suitable For

Patients who are typically recommended for meniscectomy are those with:

  1. Meniscal tears that are not amenable to repair, such as complex tears, tears in the avascular zone, or degenerative tears in older patients.
  2. Large tears that are causing significant pain, swelling, and limited range of motion.
  3. Tears that are causing mechanical symptoms such as locking or catching in the knee joint.
  4. Patients who are not good candidates for meniscal repair due to factors such as poor tissue quality, poor blood supply, or previous unsuccessful repair attempts.

Overall, the decision to recommend meniscectomy versus meniscal repair is based on the specific characteristics of the meniscal tear, the patient’s age, activity level, and overall health, as well as the likelihood of successful healing and long-term outcomes.

Timeline

Before meniscectomy, a patient may experience knee pain, swelling, stiffness, and limited range of motion. They may have tried conservative treatments such as rest, ice, physical therapy, and pain medication without success.

After meniscectomy, a patient will undergo surgery to remove the damaged part of the meniscus. They will then go through a period of rehabilitation, including physical therapy to regain strength and range of motion in the knee. Recovery time can vary, but most patients can return to normal activities within a few weeks to a few months.

Overall, the research suggests that meniscal repair leads to better outcomes in terms of lower rates of osteoarthritis development and improved knee function compared to meniscectomy. Patients who undergo meniscal repair may experience better long-term results and quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about meniscectomy include:

  1. What are the risks and benefits of meniscectomy compared to meniscal repair?
  2. How likely am I to develop osteoarthritis after a meniscectomy?
  3. What factors will influence the choice of treatment for my specific injury?
  4. How will my knee function and quality of life be affected by each treatment option?
  5. Are there alternative treatments or therapies I should consider before deciding on surgery?
  6. What is the success rate of meniscal repair in terms of complete healing?
  7. What is the recovery process like for each treatment option?
  8. Are there any long-term implications or complications associated with either treatment?
  9. How soon can I expect to return to my normal activities after surgery?
  10. Can you provide me with any additional resources or information to help me make an informed decision about my treatment?

Reference

Authors: Hurmuz M, Ionac M, Hogea B, Miu CA, Tatu F. Journal: Medicina (Kaunas). 2024 Mar 30;60(4):569. doi: 10.3390/medicina60040569. PMID: 38674215