Our Summary

This research paper discusses a common surgery performed by orthopedic surgeons called partial meniscectomy, which involves removing part of the meniscus (a piece of cartilage in the knee) that is torn. The study looks at the effects of this surgery on the knee and its mechanics.

When a larger part of the meniscus is removed, it puts more pressure on the cartilage in the knee, which can change how the knee works. The study suggests that using this surgery for meniscus tears in knees that have mild pre-existing arthritis and mechanical symptoms can be helpful. However, it doesn’t necessarily mean it’s better than physical therapy alone for treating a degenerative (wearing down over time) knee.

In younger people, having part of the meniscus removed might provide the same long-term relief of symptoms, allow for a quicker return to physical activities, and reduce the need for further surgery compared to repairing the meniscus. However, it might also lead to earlier onset of osteoarthritis (a type of arthritis that occurs when flexible tissue at the ends of bones wears down).

The paper concludes that treatment should be decided on a case-by-case basis, and that doctors should discuss the potential outcomes with the patient before deciding on the best course of action.

FAQs

  1. What are the biomechanical consequences of partial meniscectomy?
  2. Does partial meniscectomy provide any benefits for knees with mild preexisting arthritis and mechanical symptoms?
  3. How does partial meniscectomy impact younger populations and what are the potential long-term effects?

Doctor’s Tip

One helpful tip a doctor might give a patient about meniscectomy is to follow the post-operative rehabilitation plan closely. This typically includes physical therapy to help strengthen the muscles around the knee, improve range of motion, and aid in recovery. Adhering to this plan can help improve outcomes and reduce the risk of complications. It’s important to communicate with your healthcare team and ask any questions you may have throughout the recovery process.

Suitable For

Patients who are typically recommended for meniscectomy are those with meniscus tears that are causing mechanical symptoms such as locking, catching, or giving way of the knee. Additionally, patients with degenerative meniscus tears in knees with mild preexisting arthritis may benefit from partial meniscectomy. Younger patients may also be recommended for meniscectomy if they have a meniscus tear that is not amenable to repair and they desire earlier return to play. It is important for patients to have a shared decision-making process with their healthcare provider to discuss the potential risks and benefits of meniscectomy and to determine the most appropriate treatment plan for their specific situation.

Timeline

Before meniscectomy:

  1. Patient experiences knee pain, swelling, and limited range of motion.
  2. Patient may undergo physical therapy and conservative treatments such as rest, ice, and anti-inflammatory medication.
  3. Imaging studies such as MRI may be performed to confirm the presence of a meniscus tear.

After meniscectomy:

  1. Patient undergoes surgery to remove the torn portion of the meniscus.
  2. Patient may experience post-operative pain and swelling, and will be advised to rest and elevate the affected knee.
  3. Physical therapy will be prescribed to help regain strength and range of motion in the knee.
  4. Patient will gradually return to normal activities and sports, with guidance from their healthcare provider.
  5. Long-term outcomes may include relief of symptoms, earlier return to play in younger populations, and potential development of osteoarthritis in the affected knee over time.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with a meniscectomy procedure?
  2. How long is the recovery period after a meniscectomy and what can I expect during the recovery process?
  3. Will I need physical therapy after the procedure and for how long?
  4. Are there any alternative treatments or procedures that could be considered for my meniscus tear?
  5. What are the long-term implications of having a partial meniscectomy, particularly in terms of developing osteoarthritis?
  6. How likely is it that I will need further surgery or treatment in the future after a meniscectomy?
  7. What type of anesthesia will be used during the procedure and what are the potential side effects?
  8. How soon after the procedure can I return to normal activities, such as sports or exercise?
  9. Will I need any special accommodations or modifications to my lifestyle after a meniscectomy?
  10. How often will I need follow-up appointments to monitor my recovery progress and overall knee health?

Reference

Authors: Feeley BT, Lau BC. Journal: J Am Acad Orthop Surg. 2018 Dec 15;26(24):853-863. doi: 10.5435/JAAOS-D-17-00256. PMID: 30247309