Our Summary

This study aimed to evaluate the knowledge and practices of Polish orthopedic surgeons regarding the treatment of damaged menisci in the knee. A group of 205 surgeons were surveyed about their experience and their preferred treatment methods in 20 hypothetical patient cases. The surgeons’ responses were then compared based on their level of experience, with “experts” being defined as those who perform more than 100 knee arthroscopies per year.

The results showed that experienced and less experienced surgeons generally agreed on the treatment method for most cases. However, in 4 cases, the more experienced surgeons recommended repairing the damaged meniscus rather than removing it, which was a statistically significant difference.

The study concluded that despite the availability and proven benefits of meniscus repair techniques, many surgeons, particularly less experienced ones, still frequently opt for removal. This suggests that there is a need for further education on meniscus repair options among Polish surgeons.

FAQs

  1. What was the aim of the study conducted about the treatment of damaged menisci?
  2. Was there a significant difference in the treatment methods preferred by experienced and less experienced surgeons?
  3. According to the study, what does the preference for meniscus removal over repair among less experienced surgeons suggest?

Doctor’s Tip

A helpful tip a doctor might tell a patient about meniscectomy is to discuss with their surgeon the possibility of repairing the damaged meniscus instead of removing it. Meniscus repair can help preserve the natural structure and function of the knee joint, potentially leading to better long-term outcomes and reduced risk of complications. It is important for patients to be informed about all treatment options available to them and to make a decision that is best suited to their individual needs and goals.

Suitable For

Patients who are typically recommended meniscectomy are those with:

  1. Acute tears that are not amenable to repair
  2. Complex tears that cannot be adequately repaired
  3. Degenerative tears in older patients with minimal remaining meniscal tissue
  4. Tears in areas with poor blood supply, making repair less likely to be successful

It is important for surgeons to carefully consider the individual patient’s age, activity level, severity of the tear, and overall knee health when recommending meniscectomy as the treatment option.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain and swelling, often with difficulty moving the knee.
  2. Patient undergoes physical examination and imaging tests to diagnose the meniscus tear.
  3. Orthopedic surgeon recommends conservative treatment options such as rest, ice, physical therapy, and pain medication.
  4. If conservative treatment is unsuccessful, surgeon may recommend arthroscopic meniscectomy to remove the damaged portion of the meniscus.

After meniscectomy:

  1. Patient undergoes arthroscopic surgery to remove the damaged portion of the meniscus.
  2. Patient may experience post-operative pain, swelling, and limited range of motion.
  3. Patient undergoes physical therapy to regain strength and flexibility in the knee.
  4. Recovery time varies, but most patients can resume normal activities within a few weeks to a few months.
  5. Long-term consequences of meniscectomy may include an increased risk of osteoarthritis in the knee joint.

What to Ask Your Doctor

  1. What are the risks and benefits of meniscectomy compared to meniscus repair?
  2. How will my knee function be affected in the long term with each treatment option?
  3. What is the recovery time and rehabilitation process for meniscectomy versus meniscus repair?
  4. Are there any alternative treatments or therapies that I should consider before deciding on surgery?
  5. How many meniscectomies or meniscus repairs have you performed, and what is your success rate?
  6. What are the potential complications or long-term effects of each treatment option?
  7. How will the decision between meniscectomy and meniscus repair impact my overall knee health and function in the future?
  8. Are there any specific factors about my knee injury or overall health that may influence the best treatment option for me?
  9. What is the likelihood of needing additional surgeries or treatments in the future based on the chosen treatment option?
  10. Can you explain in detail the surgical procedure for both meniscectomy and meniscus repair, including the potential outcomes and recovery process for each?

Reference

Authors: Bąkowski P, Bąkowska-Żywicka K, Ciemniewska-Gorzela K, Piontek T. Journal: Knee Surg Sports Traumatol Arthrosc. 2022 Apr;30(4):1430-1435. doi: 10.1007/s00167-021-06612-w. Epub 2021 Jun 4. PMID: 34086095