Meniscus Tear Surgeries Compared Which is BEST for Your Patients? [Literature Review]

By dpope2020

November 15, 2024

all about meniscus surgery, dan pope, dr. david middaugh, el paso manual physical therapy, fitness pain free, fitnesspainfree, knee injury, knee meniscus surgery, knee pain, knee surgery, meniscus, meniscus exercises, meniscus injury, meniscus rehab exercises, meniscus repair, meniscus surgery, meniscus surgery decoded, meniscus tear, meniscus tear exercises, meniscus tear rehab, new meniscus surgery, orthopedics, physical therapy, torn meniscus, torn meniscus exercises

Meniscus Tear Surgeries Compared Which is BEST for Your Patients? [Literature Review]

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In today's video we go over Meniscus Tear Surgeries Compared Which is BEST for Your Patients? [Literature Review]: FPF Show Episode 152

  • 0:00 Introduction
  • 3:03 What are the different types of surgeries for meniscus tears?
  • 7:57 What is a meniscectomy?
  • 8:37 How common is the meniscectomy?
  • 9:39 Is a meniscectomy a quick fix for patients?
  • 14:43 How does a medial meniscectomy compare to a lateral meniscectomy?
  • 16:08 Is the lateral meniscectomy worse then a medial meniscus?
  • 20:55 Why are medial meniscectomies more common?
  • 22: 42 What are outcomes like after meniscectomies?
  • 26:36 What are the return to sport rates after meniscectomies?
  • 33:04 What is a meniscus repair?
  • 33:58 Should you consider meniscus repair over meniscus removal and why you should.
  • 36:33 What are the outcomes like after meniscus repair?
  • 37:18 What factors influence outcomes after meniscus repair?
  • 41:02 What are the return to sport rates after meniscus repair?
  • 43:38 Meniscectomy vs. repair when returning to sport
  • 53:16 Does the meniscus ever re-tear after repair?  If so what are the rates when does this occur on average?
  • 55:20 Who are the best candidates for meniscus repair?
  • 59:36 Does adding PRP to a meniscus repair improve outcomes?
  • 1:02:04 What is a meniscus transplant?
  • 1:03:00 Who is a good candidate for a meniscus transplant?
  • 1:06:46 What are the outcomes of a meniscus transplant?
  • 1:09:28 What are the return to sport rates after a meniscus transplant?
  • 1:12:27 - What Physical Therapists Need to Know About MENISCUS Injuries

Maybe just amputate?

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Damsted C, Skou ST, Hölmich P, Lind M, Varnum C, Jensen HP, Hansen MS, Thorlund JB. Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults-An Exploratory Analysis From the DREAM Trial. J Orthop Sports Phys Ther. 2024 May;54(5):340-349. doi: 10.2519/jospt.2024.12245. PMID: 38385220.

  2. Sedgwick MJ, Saunders C, Getgood AMJ. Systematic Review and Meta-analysis of Clinical Outcomes Following Meniscus Repair in Patients 40 Years and Older. Orthop J Sports Med. 2024 Aug 8;12(8):23259671241258974. doi: 10.1177/23259671241258974. PMID: 39131093; PMCID: PMC11311169.

  3. Marigi EM, Davies MR, Marx RG, Rodeo SA, Williams RJ 3rd. Meniscus Tears in Elite Athletes: Treatment Considerations, Clinical Outcomes, and Return to Play. Curr Rev Musculoskelet Med. 2024 Aug;17(8):313-320. doi: 10.1007/s12178-024-09907-w. Epub 2024 Jun 4. PMID: 38833135; PMCID: PMC11219605.

  4. Solsona-Carcas D, Trenado-Molina J, Buesa-Estéllez A, López-Royo MP, Bellosta-López P. Physical Therapist Interventions Versus or Combined With Surgical Treatment in Nontraumatic Degenerative Meniscal Pathology: A Systematic Review and Network Meta-Analysis. Phys Ther. 2024 May 1;104(5):pzae007. doi: 10.1093/ptj/pzae007. PMID: 38243408.

  5. Nawabi DH, Cro S, Hamid IP, Williams A. Return to play after lateral meniscectomy compared with medial meniscectomy in elite professional soccer players. Am J Sports Med. 2014 Sep;42(9):2193-8. doi: 10.1177/0363546514540271. Epub 2014 Jul 17. PMID: 25035175.

  6. Erickson BJ, Chalmers PN, D'Angelo J, Ma K, Rowe D, Ciccotti MG, Dugas JR. Performance and Return to Sports After Meniscectomy in Professional Baseball Players. Am J Sports Med. 2022 Mar;50(4):1006-1012. doi: 10.1177/03635465221074021. Epub 2022 Feb 11. PMID: 35148211.

  7. Morris JH, Magnussen RA, DiBartola AC, Aldabbeh S, Duerr RA, Kaeding CC, Flanigan DC. Patient Outcomes After Horizontal Cleavage Tear Repair: A Systematic Review. Arthroscopy. 2020 Aug;36(8):2316-2331. doi: 10.1016/j.arthro.2020.04.027. Epub 2020 Apr 28. PMID: 32360266.

  8. Fried JW, Manjunath AK, Hurley ET, Jazrawi LM, Strauss EJ, Campbell KA. Return-to-play and rehabilitation protocols following isolated meniscal repair-a systematic review. Arthrosc Sports Med Rehabil. 2021;3(1):e241–e2e7. doi: 10.1016/j.asmr.2020.07.023.

  9. Ekhtiari S, Khan M, Kirsch JM, Thornley P, Larson CM, Bedi A. Most elite athletes return to competition following operative management of meniscal tears: a systematic review. J ISAKOS. 2018;3(2):110–115. doi: 10.1136/jisakos-2017-000181.

  10. Aavikko A, Bister V, Reito A, Lindahl J. Meniscal allograft transplantation improves patient-reported outcomes in both minimal and moderate knee osteoarthritis at 1 and 2 years postoperatively. Knee Surg Sports Traumatol Arthrosc. 2023 Dec;31(12):5765-5772. doi: 10.1007/s00167-023-07625-3. Epub 2023 Nov 7. PMID: 37935798; PMCID: PMC10719142.

  11. Marcacci M, Marcheggiani Muccioli GM, Grassi A, Ricci M, Tsapralis K, Nanni G, Bonanzinga T, Zaffagnini S. Arthroscopic meniscus allograft transplantation in male professional soccer players: a 36-month follow-up study. Am J Sports Med. 2014 Feb;42(2):382-8. doi: 10.1177/0363546513508763. Epub 2013 Nov 8. PMID: 24214928.

  12. Grassi A, Bailey JR, Filardo G, Samuelsson K, Zaffagnini S, Amendola A. Return to sport activity after meniscal allograft transplantation: at what level and at what cost? A systematic review and Meta-analysis. Sports Health. 2019;11(2):123–133. doi: 10.1177/1941738118819723.

  13. Bracey L, Parsons D, Zhao AY, Agarwal AR, Mikula JD, Fraychineaud T, Thakkar SC, Doerre T, Best MJ. The cumulative incidence and risk factors associated with 5-year conversion to knee arthroplasty following primary meniscus repair or primary meniscectomy. J Orthop. 2024 Feb 10;52:17-20. doi: 10.1016/j.jor.2024.02.018. PMID: 38404702; PMCID: PMC10881408.

  14. Sedgwick MJ, Saunders C, Getgood AMJ. Systematic Review and Meta-analysis of Clinical Outcomes Following Meniscus Repair in Patients 40 Years and Older. Orthop J Sports Med. 2024 Aug 8;12(8):23259671241258974. doi: 10.1177/23259671241258974. PMID: 39131093; PMCID: PMC11311169.

  15. Husen M, Poudel K, Wang A, Saul D, Stuart MJ, Levy BA, Saris DBF, Krych AJ. Survivorship of 157 Arthroscopic Meniscal Allograft Transplants Using Bone Fixation at a Mean of 7 Years and Prognostic Factors Analysis. Am J Sports Med. 2024 Jan;52(1):96-108. doi: 10.1177/03635465231212667. PMID: 38164687.

  16. 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. 2022 Jul;30(7):2267-2276. doi: 10.1007/s00167-021-06770-x. Epub 2021 Oct 20. PMID: 34671817; PMCID: PMC9206598.

  17. Torres-Claramunt R, Morales-Avalos R, Perelli S, Padilla-Medina JR, Monllau JC. Good clinical outcomes can be expected after meniscal allograft transplantation at 15 years of follow-up. Knee Surg Sports Traumatol Arthrosc. 2023 Jan;31(1):272-278. doi: 10.1007/s00167-022-07106-z. Epub 2022 Aug 16. PMID: 35972520.

  18. Li Z, Weng X. Platelet-rich plasma use in meniscus repair treatment: a systematic review and meta-analysis of clinical studies. J Orthop Surg Res. 2022 Oct 8;17(1):446. doi: 10.1186/s13018-022-03293-0. PMID: 36209223; PMCID: PMC9548158.

  19. 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

  20. 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

  21. ESSKA Meniscus Consensus Project: Degenerative meniscus lesions

  22. Logerstedt DS, Scalzitti DA, Bennell KL, et al. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018. J Orthop Sports Phys Ther. 2018;48(2):A1‐A50. doi:10.2519/jospt.2018.0301

  23. Hagmeijer, M. H., Kennedy, N. I., Tagliero, A. J., Levy, B. A., Stuart, M. J., Saris, D. B. F., … Krych, A. J. (2019). Long-term Results After Repair of Isolated Meniscal Tears Among Patients Aged 18 Years and Younger: An 18-Year Follow-up Study. The American Journal of Sports Medicine, 036354651982608.

  24. Aprato A, Sordo L, Costantino A, Sabatini L, Barberis L, Testa D, Massè A. Outcomes at 20 Years After Meniscectomy in Patients Aged 50 to 70 Years. Arthroscopy. 2021 May;37(5):1547-1553. doi: 10.1016/j.arthro.2020.11.053. Epub 2020 Dec 9. PMID: 33307147.

Images:

  1. Medial Meniscus Source: https://commons.wikimedia.org/wiki/File:Medial_Meniscus_Injury.png Attribution: BruceBlaus / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0) Edited by fitness pain free LLC