Surgery for a Meniscus Tear?

The decision to opt for arthroscopic partial meniscectomy (APM) is one of the most commonly pondered choices in the realm of orthopedic practices. Meniscal tears are a widespread concern cutting across all age groups, with a particular surge in individuals aged 40 and above. Astonishingly, statistics show that 75% of those who undergo APM are in this older age bracket. Why? There's a myriad of reasons, including age-related degeneration, knee instability, and the inevitable loss of proprioception that comes with the passing years.

Here's a striking fact: around 60% of MRI scans for asymptomatic adults over 50, who have radiographic evidence of osteoarthritis, reveal incidental meniscal tears. In simple terms, if you were to take 100 people over the age of 50 off the street, with no knee pain to speak of, 60% of them would unknowingly bear the marks of a meniscal tear.

Now, the real question is to operate or not to operate? In a recent study, renowned orthopedic surgeons worldwide were consulted for their expert opinions. They were asked to predict whether APM or exercise therapy would serve as the better approach for a patient two years post-treatment. The intriguing outcome? These professionals could only forecast surgery as a more suitable choice with a mere 50% accuracy.

While individual cases are unique, this study suggests that exercise therapy might offer a more conservative and beneficial alternative for those grappling with meniscus-related knee pain. Please keep in mind that the information provided here is not intended as medical advice. For personalized guidance and a thorough discussion of your options, it is paramount to consult your healthcare provider. Your unique circumstances will play a pivotal role in determining the best path towards recovery and well-being.

Reference: 

van de Graaf VA, Bloembergen CH MD, Willigenburg NW PhD, Noorduyn JCA MSc, Saris DB, Harris IA, Poolman RW; ESCAPE Research Group. Can even experienced orthopaedic surgeons predict who will benefit from surgery when patients present with degenerative meniscal tears? A survey of 194 orthopaedic surgeons who made 3880 predictions. Br J Sports Med. 2020 Mar;54(6):354-359. doi: 10.1136/bjsports-2019-100567. Epub 2019 Aug 1. PMID: 31371339; PMCID: PMC7057800.