Our Summary

This research paper compares two surgical treatments for a common knee injury, a tear in the back part of the medial meniscus (a type of cartilage in the knee). The two treatments are repair of the tear and meniscectomy (removal of the damaged part of the meniscus). Previous studies have suggested that repair is better than meniscectomy, but those studies only looked at short-term results or were not high-quality studies.

This study used data from multiple high-quality studies to compare the two treatments. It looked at the rate of osteoarthritis (a disease that damages the joints) and the need for total knee replacement surgery at least four years after the initial surgery.

The study found that patients who had the repair surgery were less likely to develop osteoarthritis and less likely to need a knee replacement than patients who had meniscectomy. However, there was no significant difference in knee function scores between the two groups.

The researchers concluded that repair of the tear should be considered, especially when the degenerative changes in the knee are not severe, as it can lead to better outcomes in the long term.

FAQs

  1. What are the two surgical treatments compared in this study for a tear in the back part of the medial meniscus?
  2. What were the long-term outcomes of repair surgery versus meniscectomy according to this study?
  3. Does the study show any significant difference in knee function scores between repair and meniscectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about meniscectomy is that it is important to follow a comprehensive rehabilitation program after surgery to regain strength, flexibility, and range of motion in the knee. This will help improve overall function and reduce the risk of complications or further injury. It is also important to follow any post-operative instructions provided by the surgeon to ensure proper healing and recovery.

Suitable For

Patients who are typically recommended meniscectomy are those who have a tear in the meniscus that is not suitable for repair, such as tears in the avascular zone where blood supply is limited, complex tears, or tears in older patients with degenerative changes in the knee. Meniscectomy may also be recommended for patients who have already tried conservative treatments such as physical therapy and medication without success. Additionally, patients with certain medical conditions that may increase the risk of complications with repair surgery may also be recommended meniscectomy.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient undergoes diagnostic tests such as an MRI to confirm the tear in the meniscus.
  3. Patient consults with an orthopedic surgeon to discuss treatment options.
  4. Patient decides to undergo meniscectomy surgery.

After meniscectomy:

  1. Patient undergoes the surgical procedure to remove the damaged part of the meniscus.
  2. Patient goes through post-operative rehabilitation and physical therapy to regain strength and range of motion in the knee.
  3. Patient experiences temporary pain and swelling after surgery.
  4. Patient gradually resumes normal activities and sports with the guidance of a physical therapist.
  5. Long-term outcomes are monitored, including the development of osteoarthritis and the need for total knee replacement surgery.

What to Ask Your Doctor

  1. What are the potential risks and benefits of meniscectomy compared to meniscus repair for my specific knee injury?
  2. How long is the recovery time for meniscectomy compared to meniscus repair?
  3. Will I be able to return to my normal activities after meniscectomy or meniscus repair?
  4. How likely am I to develop osteoarthritis or need a total knee replacement in the future with each treatment option?
  5. Are there any alternative treatments to meniscectomy or meniscus repair that I should consider?
  6. What is the success rate of meniscectomy compared to meniscus repair in terms of long-term outcomes?
  7. How experienced are you in performing meniscectomy and meniscus repair surgeries?
  8. Are there any specific factors about my knee injury that may make one treatment option more suitable for me than the other?
  9. What is the expected post-operative rehabilitation process for meniscectomy or meniscus repair?
  10. Can you provide me with any additional information or resources to help me make an informed decision about my treatment options?

Reference

Authors: Krivicich LM, Kunze KN, Parvaresh KC, Jan K, DeVinney A, Vadhera A, LaPrade RF, Chahla J. Journal: Am J Sports Med. 2022 Jun;50(7):2023-2031. doi: 10.1177/03635465211017514. Epub 2021 Jul 12. PMID: 34251898