Our Summary

This study looked into the rates and reasons of failure for a specific type of knee surgery called a “ramp repair.” The researchers wanted to see how often a second surgery, called a meniscectomy, was needed after the initial ramp repair, and what factors might increase the risk of needing this secondary surgery.

They studied over a thousand patients who had undergone ramp repair surgery between 2013 and 2020. They found that about 7.7% of patients needed a secondary meniscectomy at some point after their initial surgery.

Interestingly, they found that patients who only had one type of surgery (anterior cruciate ligament reconstruction, or ACLR) were over twice as likely to need a secondary meniscectomy, compared to those who had both an ACLR and a lateral extra-articular procedure (LEAP) at the same time.

They also found that factors like age, gender, pre-surgery physical activity level, and time between injury and surgery didn’t significantly affect the likelihood of needing a second surgery.

In simpler terms, this study found that patients who have both an ACLR and LEAP are less likely to need a second surgery after their initial knee repair. But more research is needed to understand exactly why this is the case.

FAQs

  1. What is the percentage of patients who required a secondary meniscectomy after an initial ramp repair surgery?
  2. Are patients who undergo only an ACLR more likely to need a meniscectomy compared to those who also have a LEAP?
  3. Do factors like age, gender, pre-surgery physical activity level, and time between injury and surgery affect the likelihood of needing a second surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about meniscectomy is to follow their post-operative rehabilitation plan carefully. This may include physical therapy exercises to strengthen the knee and improve range of motion. By following the recommended rehab plan, patients can help prevent complications and reduce the risk of needing a second surgery.

Suitable For

Patients who are typically recommended for a meniscectomy are those who have a torn meniscus that is causing significant pain, swelling, and limited mobility in the knee joint. Meniscectomy is often recommended when conservative treatments such as rest, physical therapy, and anti-inflammatory medications have not been effective in relieving symptoms. Additionally, patients with complex meniscus tears, recurrent symptoms, or those who have failed previous meniscus repair surgeries may also be candidates for a meniscectomy.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient undergoes physical examination, imaging tests (such as MRI), and possibly non-surgical treatments like physical therapy or injections.
  3. Surgeon recommends meniscectomy as a treatment option for a torn meniscus.

After meniscectomy:

  1. Patient undergoes meniscectomy surgery to remove the torn portion of the meniscus.
  2. Patient goes through a period of recovery, which may include pain management, physical therapy, and gradually increasing activity levels.
  3. Patient returns to normal activities and sports over time, with improvements in knee function and reduced pain.
  4. In some cases, patient may experience persistent knee pain or limited function, leading to the need for a second surgery, such as a revision meniscectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about meniscectomy include:

  1. What is the success rate of meniscectomy in general, and specifically for my condition?
  2. Are there any alternative treatments or procedures to consider before opting for a meniscectomy?
  3. What are the potential risks and complications associated with meniscectomy?
  4. How long is the recovery process after a meniscectomy, and what can I expect in terms of pain and mobility?
  5. Will I need physical therapy after the surgery, and if so, for how long?
  6. Are there any long-term effects or consequences of having a meniscectomy?
  7. What is the likelihood of needing a second surgery, such as a revision meniscectomy, in the future?
  8. Are there any specific factors about my injury or knee anatomy that may affect the outcome of the surgery?
  9. What is the expected timeline for returning to normal activities, such as sports or exercise, after a meniscectomy?
  10. Are there any lifestyle or behavior changes I should make to optimize the success of the surgery and prevent future knee injuries?

Reference

Authors: Pioger C, Ayata M, Pettinari F, Ali AA, Alayane A, Campos JP, Vieira TD, Saithna A, Sonnery-Cottet B. Journal: Am J Sports Med. 2024 Jul;52(8):1944-1951. doi: 10.1177/03635465241253841. Epub 2024 Jun 10. PMID: 38853744