Our Summary

This research study took place in the Netherlands and looked at two different treatments for people aged 45 to 70 who have a certain type of knee injury - a degenerative meniscal tear. This injury often happens as people age and their knee cartilage starts to wear down. The two treatments studied were a type of knee surgery called arthroscopic partial meniscectomy, and physical therapy involving 16 sessions of specific exercises.

321 patients participated in the study, and they were randomly chosen to receive either the surgery or the physical therapy. The researchers then followed up with the patients over a five-year period to see how well they were doing. They measured the patients’ knee function using a scale from 0 to 100, with 100 being the best possible function. They also took x-rays of the patients’ knees to see if their osteoarthritis (a condition that causes joints to become painful and stiff) was getting worse.

In the end, the researchers found that both treatments led to improvements in knee function over the five-year period, but the surgery group had a slightly higher average improvement. However, this difference was not large enough to be considered significant, meaning that physical therapy was just as effective as surgery in the long term. The x-rays also showed that both treatments had similar rates of osteoarthritis progression.

The researchers concluded that physical therapy should be the preferred treatment for degenerative meniscal tears, as it is just as effective as surgery but less invasive. The findings of this study can be used to guide treatment recommendations for patients with this type of knee injury.

FAQs

  1. What is a degenerative meniscal tear and who are most likely to experience it?
  2. What were the two treatments compared in the research study and how were they evaluated?
  3. Did the study find a significant difference in effectiveness between physical therapy and arthroscopic partial meniscectomy for treating degenerative meniscal tears?

Doctor’s Tip

One helpful tip a doctor might tell a patient about meniscectomy is to consider physical therapy as a first-line treatment option before opting for surgery. Physical therapy can be just as effective in improving knee function and may have fewer risks and complications compared to surgery. It is important for patients to discuss their treatment options with their healthcare provider and make an informed decision based on their individual needs and preferences.

Suitable For

Patients who are typically recommended for meniscectomy are those with degenerative meniscal tears, especially those aged 45 to 70. These tears often occur as people age and their knee cartilage starts to wear down. Patients with this type of knee injury may experience pain, swelling, and limited range of motion in the affected knee. Meniscectomy may be recommended for patients who have not responded well to conservative treatments such as rest, physical therapy, and medications. It is important for patients to discuss their treatment options with their healthcare provider to determine the best course of action for their specific situation.

Timeline

Before the meniscectomy, a patient would typically experience knee pain, swelling, and difficulty with activities such as walking or climbing stairs. They may have tried conservative treatments such as rest, ice, medication, and physical therapy without significant improvement.

After the surgery, the patient would undergo a period of recovery and rehabilitation. This may involve using crutches, wearing a knee brace, and attending physical therapy sessions to regain strength and range of motion in the knee. The patient may experience some pain and swelling in the immediate post-operative period, but this should gradually improve with time.

Over the long term, the patient may continue to work on strengthening the knee and improving their overall function. They may be able to return to their normal activities and sports, but it is important to follow a proper rehabilitation program to prevent further injury or complications.

In the case of this study, patients who underwent physical therapy instead of surgery showed similar improvements in knee function over a five-year period. This suggests that physical therapy can be a successful alternative to surgery for degenerative meniscal tears, with potentially fewer risks and complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with arthroscopic partial meniscectomy?
  2. How long is the recovery time for arthroscopic partial meniscectomy compared to physical therapy?
  3. Are there any long-term effects or consequences of undergoing arthroscopic partial meniscectomy?
  4. How likely is it that the meniscal tear will reoccur after arthroscopic partial meniscectomy?
  5. Are there any alternative treatments or therapies that could be considered instead of surgery?
  6. What are the success rates of arthroscopic partial meniscectomy in improving knee function?
  7. How will physical therapy help improve knee function and manage symptoms of a degenerative meniscal tear?
  8. Are there any specific exercises or techniques that are recommended as part of the physical therapy treatment plan?
  9. What are the potential risks or limitations of choosing physical therapy over surgery for a degenerative meniscal tear?
  10. How will the decision between surgery and physical therapy be personalized based on my individual health, lifestyle, and preferences?

Reference

Authors: Noorduyn JCA, van de Graaf VA, Willigenburg NW, Scholten-Peeters GGM, Kret EJ, van Dijk RA, Buchbinder R, Hawker GA, Coppieters MW, Poolman RW; ESCAPE Research Group. Journal: JAMA Netw Open. 2022 Jul 1;5(7):e2220394. doi: 10.1001/jamanetworkopen.2022.20394. PMID: 35802374