Our Summary

This research paper explores how the use of a knee surgery called arthroscopic meniscectomy has changed in Spain between 2003 and 2018. Although several studies have shown that this surgery is not superior to non-surgical treatments in middle-aged and older adults, it remains one of the most common operations.

The researchers analyzed data on all 420,228 arthroscopic meniscectomies performed in Spain during this period. They found that the rate of these surgeries increased by 33%. The procedure became more common in older patients, despite evidence that it may not be the best treatment option for them.

The study also found that the proportion of these surgeries performed as outpatient procedures (meaning the patient goes home the same day) increased from 32% in 2003 to 67% in 2018.

The researchers suggest that health systems need to take action to reduce the use of procedures that may not be the best choice for patients. This could include financial incentives, regulations, or efforts to share the latest research with doctors and patients. More research is needed to understand why these surgeries are still so common despite evidence that they may not be the best choice.

FAQs

  1. What is the trend in the use of arthroscopic meniscectomy in Spain between 2003 and 2018?
  2. Despite evidence suggesting it may not be the best treatment option, why has the procedure become more common in older patients?
  3. What measures do researchers suggest can be taken to reduce the use of procedures that may not be the best choice for patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about meniscectomy is to carefully consider all treatment options and discuss them with your healthcare provider. It’s important to understand the potential risks and benefits of surgery, as well as the effectiveness of non-surgical treatments. Additionally, patients should ask about the latest research and guidelines to make an informed decision about their care.

Suitable For

Typically, patients who are recommended for meniscectomy are those with a torn meniscus in the knee that is causing significant pain, swelling, and limited function. These patients may have tried non-surgical treatments such as physical therapy, rest, and medication without success. Meniscectomy is often recommended for younger patients, particularly athletes, who want to return to their previous level of activity as quickly as possible.

However, as the research paper mentioned above highlights, the use of meniscectomy has also been common in older patients despite evidence that it may not be the best treatment option for them. This suggests that there may be a lack of awareness among healthcare providers and patients about the risks and benefits of this surgery in different patient populations.

It is important for healthcare providers to carefully evaluate each patient’s individual circumstances and consider factors such as age, activity level, overall health, and treatment goals when recommending meniscectomy. Patients should also be informed about alternative treatment options and the potential risks and benefits of surgery before making a decision.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient may undergo physical therapy, medications, and other conservative treatments to manage symptoms.
  3. Patient may undergo imaging tests such as MRI to confirm diagnosis of meniscus tear.
  4. Patient and doctor discuss treatment options, including surgery.

After meniscectomy:

  1. Patient undergoes arthroscopic meniscectomy surgery to remove all or part of the damaged meniscus.
  2. Patient may experience post-operative pain, swelling, and stiffness.
  3. Patient undergoes rehabilitation and physical therapy to regain strength and range of motion in the knee.
  4. Patient gradually resumes normal activities and sports, following doctor’s recommendations.
  5. Patient may still experience some knee pain and limitations in the long term, especially if the surgery was performed in older patients.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a meniscectomy surgery?
  2. Are there alternative treatment options available for my condition?
  3. What is the success rate of meniscectomy surgery in patients like me?
  4. How long is the recovery period after undergoing a meniscectomy?
  5. Will I need physical therapy after the surgery?
  6. What are the potential complications associated with this surgery?
  7. How will my daily activities be affected after undergoing a meniscectomy?
  8. Are there any long-term effects of having a meniscectomy surgery?
  9. How many meniscectomy surgeries have you performed, and what is your success rate?
  10. Can you provide me with any additional information or resources about meniscectomy surgery?

Reference

Authors: López-Vega M, Doménech-Fernández J, Peiró S, Ridao-López M. Journal: Clin Orthop Relat Res. 2023 Jan 1;481(1):7-16. doi: 10.1097/CORR.0000000000002421. Epub 2022 Oct 3. PMID: 36190489