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A Torn Meniscus Does Not Mean You Need Surgery

A Torn Meniscus Does Not Mean You Need Surgery

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Medial Meniscus InjuryWe live in a society where the mentality has been, “If it’s broken, fix it!”  For many orthopedic injuries, most people seek out a good surgeon to undergo surgery for whatever happens to be torn, ripped, or bulging.  Our surgical techniques and outcomes are we have these days are superb.  However, there has been a lot of new research coming out about the treatment of meniscal tears of the knee.  Surgical intervention may not be the best way to “fix” a meniscal tear.

 

 

Research shows these reasons why you should NOT choose surgery as your first line of treatment for meniscal tears:

  • Equivalent outcomes in pain and function after 1 year compared to those who have surgery
  • Surgery puts you at a 3x higher risk of needing a total knee replacement in the future

A huge study just came out in 2016 by Graff et al comparing surgical intervention of meniscal tears to conservative treatment.  773 patients were studied.  This is a very large sample size so good evidence!  Those patients who had surgery showed just slightly better improvements in physical function and pain at 2-3 months and 6 months.  But, after 12 months and 24 months, the outcomes between both groups were the same.  This means that the patient who had arthroscopic surgery was functioning better initially, but beyond 6 months, those who didn’t have surgery were doing just as good.  So why undergo the risk of surgery?

Another interesting study just published in Oct of this year actually found that those patients who had arthroscopic treatment for a meniscectomy (or partial removal of the injured meniscus which is the standard treatment for tears unless you are really young) were at a higher risk of needing a total knee replacement in the future.  J.J. Rongen studied 4,674 patients and those who had surgery for meniscal tears were 3 times at risk of needing a joint replacement compared to those who did not have surgery!

There are specific cases of meniscal tears that we know do require surgery.  Those who have a bucket tear, or displaced tear (like Adrian Peterson had) definitely require surgery to fix this tear.  The meniscus splits and then lifts up into the joint causing a great deal of pain, swelling, and limited motion.  Patients don’t respond as well to PT as those who just have a small tear or split in the meniscus.

If you or someone you know has been diagnosed with a torn meniscus, surgery may not be the best option.  Knowing you would have the same outcome by just doing physical therapy and resting your knee vs. being cut open in surgery and placing yourself at risk that surgery involves, why not choose the conservative option?

– Nicole

 

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Van de Graff et al, “Arthroscopic Partial Meniscal or Conservative Treatment for Nonobstructive Meniscal Tears: A Systematic Review and Meta-analysis of Randomized Controlled Trials.” Arthroscopy. 2016 Sept;32(9):1855-1865.

J.J. Rongen. “Increased Risk for Knee Replacement Surgery After Arthroscopic Surgery for Degenerative Meniscal Tears: A Multi-center Longitudinal Observational Study Using Data from the Osteoarthritis Initiative.” Osteoarthritis and Cartilage. Published Online Oct 3, 2016.

 

Nicole Dahmes

Nicole Dahmes

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