• Are you considering knee surgery after being diagnosed with a meniscus tear? Or, did you have a prior meniscus surgery several years ago and now have a diagnosis of osteoarthritis? The October article of the month may interest you!

    This month’s study comes from Finland. In this multicenter study patients who were found to have a degenerative medial meniscus tear (verified by MRI & no signs of OA) were randomized to either receiving a meniscectomy or a placebo surgery. Wait…. A placebo surgery?!? You read that right, the placebo surgery consisted of a diagnostic arthroscopy but no part of the meniscus or the damaged tissue was removed or disturbed. Those clever researchers!

    Clinicians hypothesized that by removing the damaged meniscus the patients would be less at risk for Osteoarthritis. Osteoarthritis is the most common form of arthritis and occurs when cartilage (like the meniscus found in your knee) wears down. Symptoms include pain, stiffness, loss of movement and swelling. This can prevent someone from doing the activities they love such as skiing, walking and running.

     Going back to the study - The patients who were randomized into one of the groups were then followed for FIVE YEARS. The results were shocking.

    After five years the researchers assessed the patient’s level of osteoarthritis, knee pain, joint space narrowing and level of function.

    The results showed that there was NO difference in patient-reported pain and level of function. HOWEVER, the group that got the real surgery had a HIGHER risk for progression of osteoarthritis and MORE symptoms.

     So what does this mean for you?

    If you have been diagnosed with a meniscus tear - you may try physical therapy as your first line of treatment before lining up for surgery. Unfortunately, despite results similar to the ones found in this recent report, partial meniscectomies are still extremely common treatments for this patient group and is one of the most common orthopedic procedures. Reading the results of this study we highly encourage clinicians and patients to consider alternatives before progressing with a partial meniscectomy.  

    If you have had this surgery in the past and you have now been diagnosed with osteoarthritis, exercise therapy overseen by a physical therapist is a safe effective solution for managing symptoms and should be a first-line treatment offered to people with hip and knee osteoarthritis. 

     

    Stay Safe, Stay Healthy, Stay Bodywise!

     

    References:

    Sihvonen R, Paavola M, Malmivaara A, et al. Arthroscopic partial meniscectomy for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial. British Journal of Sports Medicine Published Online First: 27 August 2020. doi: 10.1136/bjsports-2020-102813

    Skou ST, Pedersen BK, Abbott JH, Patterson B, Barton C. Physical Activity and Exercise Therapy Benefit More Than Just Symptoms and Impairments in People With Hip and Knee Osteoarthritis. J Orthop Sports Phys Ther. 2018 Jun;48(6):439-447. doi: 10.2519/jospt.2018.7877. Epub 2018 Apr 18. PMID: 29669488.