Our Summary

The paper discusses whether it is better to repair or remove part of the meniscus, a piece of cartilage in the knee, when it is torn. There is a debate about this because removing part of the meniscus can potentially lead to increased pressure on the knee and result in early onset of arthritis. Most doctors prefer to try and save the meniscus, but only a small number of tears can actually be repaired. Two recent studies suggest that removing part of the meniscus can have similar short-term results to repairing it. However, it’s still uncertain whether these results can be maintained over a longer period.

FAQs

  1. What is the controversy surrounding the decision to repair or resect meniscal tears?
  2. Does partial meniscectomy increase the risk of early cartilage degeneration and osteoarthritis?
  3. What do recent registry studies suggest about the outcomes of partial meniscectomy in the short term?

Doctor’s Tip

One helpful tip a doctor might tell a patient about meniscectomy is to follow post-operative rehabilitation and physical therapy protocols closely to ensure proper healing and to minimize the risk of long-term complications. Physical therapy can help improve strength, flexibility, and range of motion in the knee, which can aid in recovery and prevent further injury. It is important to communicate any concerns or changes in symptoms to your healthcare provider during the healing process.

Suitable For

Patients who are typically recommended for meniscectomy are those with symptomatic meniscal tears that are not amenable to repair. This includes patients with degenerative tears, complex tears, tears in the avascular zone, and tears in patients with underlying arthritis. Additionally, patients who have failed conservative treatment options such as physical therapy and medications may also be recommended for meniscectomy. It is important to note that the decision to undergo meniscectomy should be made on a case-by-case basis, taking into consideration the patient’s age, activity level, and overall health.

Timeline

Before meniscectomy:

  1. Patient experiences pain, swelling, and limited range of motion in the knee.
  2. Patient undergoes physical examination and imaging tests (such as MRI) to confirm a meniscal tear.
  3. Patient may undergo conservative treatments such as rest, ice, physical therapy, and corticosteroid injections to manage symptoms.

After meniscectomy:

  1. Patient undergoes arthroscopic surgery to remove the damaged part of the meniscus.
  2. Patient goes through a rehabilitation program to regain strength and range of motion in the knee.
  3. Patient may experience temporary pain, swelling, and stiffness after surgery.
  4. Over time, patient’s symptoms improve and they are able to return to normal activities.
  5. Long-term outcomes of meniscectomy may include increased risk of early cartilage degeneration and osteoarthritis in the affected knee.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a meniscectomy procedure?
  2. How long will the recovery process take after a meniscectomy?
  3. Will I need physical therapy after the procedure?
  4. Are there any alternative treatments to meniscectomy that I should consider?
  5. How likely is it that I will develop osteoarthritis in the future if I undergo a meniscectomy?
  6. What are the potential long-term effects of a meniscectomy on my knee joint?
  7. How successful is meniscal repair compared to meniscectomy in terms of outcomes and recovery?
  8. Are there any specific factors about my meniscus tear that may influence the decision between repair and resection?
  9. What is the likelihood of needing additional surgery in the future after undergoing a meniscectomy?
  10. Can you provide me with information or resources to help me make an informed decision about undergoing a meniscectomy?

Reference

Authors: Hohmann E. Journal: Arthroscopy. 2020 Apr;36(4):1154-1155. doi: 10.1016/j.arthro.2020.01.010. PMID: 32247411