Our Summary

This research paper discusses a type of knee surgery called arthroscopic partial meniscectomy (APM), which is used to treat tears in the meniscus, a piece of cartilage in your knee that cushions and stabilizes the joint. It states that this surgery isn’t beneficial for treating general wear and tear of the joint, and non-surgical treatments should be tried first for these types of tears.

APM is most effective for treating meniscal tears that are caused by an injury and cause symptoms like pain, locking, or catching in the knee. However, the paper also notes that women, people who are overweight, and people with tears in a certain part of the meniscus (the lateral part) may not be as satisfied with the results of the surgery.

In addition, if a patient has other joint issues, such as arthritis, inflammation, or ligament damage, these can negatively affect the outcome of the surgery. The paper particularly highlights an issue where the cartilage starts to peel or break off, which the surgeon might term as “impending loose bodies.” In these cases, a different type of surgery to repair the cartilage may be necessary.

FAQs

  1. What are the indications for arthroscopic partial meniscectomy (APM)?
  2. What factors can lead to dissatisfaction with APM?
  3. When might cartilage repair surgery be recommended in cases of degenerative meniscal tears?

Doctor’s Tip

After a meniscectomy, it is important to follow your doctor’s rehabilitation plan, which may include physical therapy exercises to strengthen the muscles around the knee and improve range of motion. It is also important to avoid activities that put excessive strain on the knee, such as running or jumping, until cleared by your doctor. Following these recommendations can help improve your recovery and reduce the risk of complications.

Suitable For

Meniscectomy is typically recommended for patients with traumatic tears that have clear mechanical symptoms such as locking and catching, joint-line pain, or acute onset of symptoms that have failed nonsurgical treatment. Factors that may predict dissatisfaction with meniscectomy include female sex, obesity, and lateral meniscal tears. Patients with concomitant joint pathology, such as chondral damage or signs of inflammation, may have poorer outcomes with meniscectomy. In cases where there is evidence of chondral lesions that may lead to loose bodies, cartilage repair surgery may be indicated.

Timeline

Before meniscectomy:

  • Patient may experience symptoms such as pain, swelling, and limited range of motion in the affected knee
  • Initial nonoperative management, such as rest, ice, physical therapy, and anti-inflammatory medications, may be recommended
  • If symptoms persist or worsen, the patient may undergo diagnostic imaging, such as MRI, to confirm the presence of a meniscal tear
  • Indications for meniscectomy include traumatic tears with mechanical symptoms, such as locking and catching, and acute onset of symptoms that have not improved with nonsurgical treatment

After meniscectomy:

  • Patient will undergo arthroscopic partial meniscectomy (APM) to remove the damaged portion of the meniscus
  • Recovery typically involves physical therapy to regain strength and range of motion in the knee
  • Predictors of dissatisfaction with APM include female sex, obesity, and lateral meniscal tears
  • Concomitant joint pathology, such as chondral damage, subchondral bone changes, inflammation, or ligament pathology, can negatively affect outcomes of APM
  • In cases where chondral lesions are present, cartilage repair surgery may be indicated to prevent further joint damage.

What to Ask Your Doctor

  1. What are the risks and potential complications of a meniscectomy procedure?
  2. How long is the recovery time after a meniscectomy?
  3. Will I need physical therapy after the surgery, and if so, for how long?
  4. What are the chances of the meniscus tearing again after the surgery?
  5. Are there any alternative treatments or procedures that could be considered instead of a meniscectomy?
  6. How will a meniscectomy affect my long-term joint health and risk of developing osteoarthritis?
  7. What can I do to help prevent further damage to my meniscus in the future?
  8. How soon can I return to my normal activities, such as sports or exercise, after a meniscectomy?
  9. Are there any lifestyle changes or modifications I should make post-surgery to promote healing and prevent complications?
  10. What are the expected outcomes and success rates of a meniscectomy for my specific case?

Reference

Authors: Roemer FW. Journal: Arthroscopy. 2022 Mar;38(3):945-947. doi: 10.1016/j.arthro.2021.07.036. PMID: 35248238