Our Summary

This study looked at factors that could predict differences in patient-reported outcomes before and after a specific type of knee surgery called arthroscopic meniscectomy. The researchers used a measure known as the Knee injury and Osteoarthritis Outcome Score (KOOS) to assess patient outcomes. They looked at patients who underwent this surgery performed by the same surgeon at a particular hospital between January 2012 and March 2018.

The researchers found that Medicaid insurance and being black were significant predictors of worse outcomes both before and after the surgery. Patients with Medicaid insurance were also less likely to have a successful surgery, as were patients with moderate osteoarthritis as shown by radiographic imaging (as opposed to those with no clear evidence of osteoarthritis). Patients who had worse KOOS scores before the surgery also had worse scores after the surgery and were less likely to have a successful surgery.

The researchers suggest these differences might be due to disparities in access to orthopaedic care for people with meniscus tears who have Medicaid insurance. They also suggest that patients with meniscus tears and evidence of osteoarthritis should be carefully evaluated to determine if this type of surgery is appropriate for them.

FAQs

  1. What is the Knee injury and Osteoarthritis Outcome Score (KOOS) used for in the study?
  2. What factors did the study find to predict worse outcomes before and after arthroscopic meniscectomy?
  3. What are the researchers’ suggestions for patients with meniscus tears and evidence of osteoarthritis who are considering arthroscopic meniscectomy?

Doctor’s Tip

A doctor might advise a patient undergoing meniscectomy to discuss their insurance coverage and potential barriers to care with their healthcare provider. They may also recommend discussing any existing osteoarthritis and the potential impact on surgical outcomes. Additionally, the doctor may stress the importance of pre-operative preparation and post-operative rehabilitation to optimize the success of the surgery.

Suitable For

In summary, patients who are typically recommended for meniscectomy are those with meniscus tears, moderate osteoarthritis, and good insurance coverage. Patients with Medicaid insurance, black patients, and those with worse KOOS scores before surgery may have worse outcomes and may not be good candidates for this type of surgery. These patients may require careful evaluation and consideration of alternative treatment options.

Timeline

Before the meniscectomy:

  • Patient experiences pain, swelling, and limited range of motion in the knee
  • Patient may undergo physical therapy, corticosteroid injections, or other conservative treatments
  • Patient may have imaging tests such as X-rays or MRI to diagnose the meniscus tear
  • Patient may be referred to an orthopedic surgeon for evaluation

After the meniscectomy:

  • Patient undergoes arthroscopic meniscectomy surgery to remove the damaged part of the meniscus
  • Patient may experience post-operative pain, swelling, and stiffness
  • Patient undergoes physical therapy to regain strength and range of motion in the knee
  • Patient gradually returns to normal activities and sports, avoiding high-impact activities that could damage the remaining meniscus
  • Patient follows up with the surgeon for post-operative appointments and monitoring of their progress
  • Patient reports their outcomes using measures such as the KOOS score to assess the success of the surgery and their overall knee function.

What to Ask Your Doctor

  1. What is the success rate of meniscectomy for patients with my specific condition and characteristics?

  2. Are there alternative treatment options that may be more appropriate for me?

  3. What are the potential risks and complications associated with meniscectomy?

  4. How long is the recovery process and what can I expect in terms of pain and mobility during this time?

  5. Will I need physical therapy after the surgery, and if so, for how long?

  6. What can I do to optimize my chances of a successful outcome from the surgery?

  7. How will my insurance coverage affect my ability to undergo this surgery and receive follow-up care?

  8. Are there any lifestyle changes I should make before or after the surgery to improve my recovery and long-term outcomes?

  9. Can you provide me with more information about the specific techniques and technologies you use for meniscectomy, and how they may impact my results?

  10. How often do you perform meniscectomy surgeries, and what is your experience and success rate with this procedure?

Reference

Authors: Bloise C, Fong B, Jeffers K, Bronstone A, Leonardi C, Veale T, Poche J, Dasa V. Journal: J Knee Surg. 2023 Jun;36(7):792-800. doi: 10.1055/s-0042-1743229. Epub 2022 Feb 25. PMID: 35213921