When SHOULD and SHOULDN’T Your Patients Have Meniscus Surgery? | Meniscectomy, Meniscus Repair : FPF Show Episode 25

By dpope2020

March 18, 2022

dan pope, fitness pain free, knee injury, knee pain, knee surgeon, knee surgery, meniscal repair, meniscal tear, meniscectomy, meniscus injury, meniscus repair, meniscus surgery, meniscus tear, orthopaedic surgery, orthopedic surgery, partial meniscectomy, physical therapy, physiotherapy, sports doctor, sports injury, sports medicine, torn meniscus

When SHOULD and SHOULDN'T Your Patients Have Meniscus Surgery? | Meniscectomy, Meniscus Repair

In today's episode we go over When SHOULD and SHOULDN'T Your Patients Have Meniscus Surgery? | Meniscectomy, Meniscus Repair

  • 0:00 Intro
  • 2:17 Why is the meniscus so important (What is the meniscus, function, relevant anatomy)
  • 5:34 What happens to the knee joint after a meniscus tear (Relationship between meniscus pathology and arthritis)
  • 6:45 How partial meniscectomies lead to arthritis over time
  • 8:50 Do meniscus tears heal over time? (age, time since injury, tear type, tear location)
  • 11:19 What types of meniscus tears can be repaired?
  • 13:55 Which surgery is superior, meniscus repair or menisectomy?
  • 15:49 What are the rates of knee arthritis following meniscectomy and meniscus repair compared to normal knees?
  • 16:33 What percentage of meniscus repairs will fail?
  • 17:22 Meniscectomy vs Meniscus repair vs. Physical Therapy (traumatic tears)
  • 21:24 Who SHOULDN'T have a meniscectomy?
  • 24:20 Who SHOULD have a meniscectomy?
  • 25:10 How long should you perform physical therapy before considering surgery?
  • 25:37 When should you have a meniscus repair?
  • 26:34 What you need to look for in a surgeon for meniscus surgery
  • 28:58 References

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Dawson LJ, Howe TE, Syme G, Chimimba LA, Roche JJW. Surgical versus conservative interventions for treating meniscal tears of the knee in adults. Cochrane Database Syst Rev. 2017;2017(9):CD011411. Published 2017 Sep 7. doi:10.1002/14651858.CD011411.pub2

  2. Persson F, Turkiewicz A, Bergkvist D, Neuman P, Englund M. The risk of symptomatic knee osteoarthritis after arthroscopic meniscus repair vs partial meniscectomy vs the general population. Osteoarthritis Cartilage. 2018 Feb;26(2):195-201. doi: 10.1016/j.joca.2017.08.020. Epub 2017 Nov 14. PMID: 29146386.

  3. Weber J, Koch M, Angele P, Zellner J. The role of meniscal repair for prevention of early onset of osteoarthritis. J Exp Orthop. 2018;5(1):10. Published 2018 Apr 2. doi:10.1186/s40634-018-0122-z

  4. Englund M, Guermazi A, Roemer FW, et al. Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: The Multicenter Osteoarthritis Study. Arthritis Rheum. 2009;60(3):831-839. doi:10.1002/art.24383

  5. Knee Image: Source: https://commons.wikimedia.org/wiki/File:917_Knee_Joint.jpg Attribution: OpenStax College / CC BY (https://creativecommons.org/licenses/by/3.0)

  6. Source: https://commons.wikimedia.org/wiki/File:Gray349.png Attribution: Henry Vandyke Carter / Public domain Edited by fitness pain free LLC

  7. Schweizer C, Hanreich C, Tscholl PM, Ristl R, Apprich S, Windhager R, Waldstein W. Nineteen percent of meniscus repairs are being revised and failures frequently occur after the second postoperative year: a systematic review and meta-analysis with a minimum follow-up of 5 years. Knee Surg Sports Traumatol Arthrosc. 2021 Oct 20. doi: 10.1007/s00167-021-06770-x. Epub ahead of print. PMID: 34671817.

  8. Skou ST, Lind M, Hölmich P, et al. Study protocol for a randomised controlled trial of meniscal surgery compared with exercise and patient education for treatment of meniscal tears in young adults. BMJ Open. 2017;7(8):e017436. Published 2017 Aug 21. doi:10.1136/bmjopen-2017-017436

  9. Abrams GD, Frank RM, Gupta AK, Harris JD, McCormick FM, Cole BJ. Trends in meniscus repair and meniscectomy in the United States, 2005-2011. Am J Sports Med. 2013 Oct;41(10):2333-9. doi: 10.1177/0363546513495641. Epub 2013 Jul 17. PMID: 23863849.

  10. Madaleno FO, Santos BA, Araújo VL, Oliveira VC, Resende RA. Prevalence of knee osteoarthritis in former athletes: a systematic review with meta-analysis. Braz J Phys Ther. 2018;22(6):437‐451. doi:10.1016/j.bjpt.2018.03.012

  11. Chirichella, P. S., Jow, S., Iacono, S., Wey, H. E., & Malanga, G. A. (2018). Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics. PM&R. doi:10.1016/j.pmrj.2018.08.384

  12. Raj MA, Bubnis MA. Knee Meniscal Tears. [Updated 2020 July]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431067/

  13. Siemieniuk RAC, Harris IA, Agoritsas T, et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: A clinical practice guideline. BMJ 2017;357:j1982

  14. Beaufils P, Becker R, Kopf S, Matthieu O, Pujol N. The knee meniscus: management of traumatic tears and degenerative lesions. EFORT Open Rev. 2017;2(5):195‐203. Published 2017 May 11. doi:10.1302/2058-5241.2.160056

  15. Hohmann E, Glatt V, Tetsworth K, Cote M. Arthroscopic Partial Meniscectomy Versus Physical Therapy for Degenerative Meniscus Lesions: How Robust Is the Current Evidence? A Critical Systematic Review and Qualitative Synthesis. Arthroscopy. 2018 Sep;34(9):2699-2708. doi: 10.1016/j.arthro.2018.04.018. Epub 2018 Jul 20. PMID: 30037571.

Thumbnail Image: https://commons.wikimedia.org/wiki/File:Medial_Meniscus_Injury.pngAttribution: BruceBlaus / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0) Edited by fitness pain free LLC