Most meniscal surgeries (95%) are partial meniscectomies where part of the meniscus is actually removed, not just repaired. Therefore, the remaining meniscus is now smaller and does not perform as well. The Meniscus is a ring-shaped piece of cartilage whose purpose is to act as a shock absorber for the knee. When a piece is removed it can’t function as well as it is meant to. Thus, when equal forces are placed onto a smaller piece of cartilage, more wear and tear and increased risk for in jury takes place.
Most recent studies have shown meniscal surgery to be no better than physical therapy or Cham surgery. This includes to recent studies from the New England Journal of Medicine, as well as a study from an orthopedic surgical journal. (1,2,3).
2 reasons why people have increased risk for pain after meniscal surgery are:
1. The meniscus can re-tear. Remember the remaining meniscus is smaller but having to work harder since pressure is on the meniscus have not changed.
2. The knee now has a significant increase in developing arthritis since part of the meniscus was removed. A study looking at knees 18 months after surgery showed 60% of knees treated with surgery had developed arthritis compared to 33% and patient’s only receiving physical therapy. (4)
What are your treatment options?
First, do not have another meniscal surgery. This will only worsen the problem. Second consider Ortho-biologic treatment such as PRP or stem cells which have been shown to be very effective in multiple trials. (5,6).
The bottom line is do not have meniscus surgery. This will only weaken your knee and lead to a significant increase in developing arthritis later in life. Come see us at Regenexx Pittsburgh for state of the art ortho-biologic treatments with PRP and Stem Cells so you can get back to high level function.
(1) Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis N Engl J Med. 2013;368(18):1675–1684. doi:10.1056/NEJMoa1301408
(2) Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Järvinen TL; Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med. 2013 Dec 26;369(26):2515-24. doi: 10.1056/NEJMoa1305189.
(3) Beaufils P, Pujol N. Management of traumatic meniscal tear and degenerative meniscal lesions. Save the meniscus. Orthop Traumatol Surg Res. 2017;103(8S):S237-S244.DOI: 10.1016/j.otsr.2017.08.003
(4) Collins JE, Losina E1,2, Marx RG3, Guermazi A, MeTeOR Investigator Group. Early MRI-based Changes in Patients with Meniscal Tear and Osteoarthritis. Arthritis Care Res (Hoboken). 2019 Apr 1. doi: 10.1002/acr.23891
(5) Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011 Apr;19(4):528-35. doi: 10.1007/s00167-010-1238-6.
(6) Southworth TM, Naveen NB, Tauro TM, Leong NL, Cole BJ. The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis. J Knee Surg. 2019 Jan;32(1):37-45. doi: 10.1055/s-0038-1675170