Your orthopedic surgeon wants to do arthroscopic surgery for your meniscus… better watch out!
Arthroscopic surgery for degenerative meniscus tears increases risk for eventual knee replacement
A recent study published in the journal Osteoarthritis Cartilage showed that patients with osteoarthritis of the knee who undergo arthroscopic surgery for degenerative meniscus tears are at markedly increased risk for potentially having total joint replacement. In the study, 335 patients with osteoarthritis of the knee underwent arthroscopic surgery for degenerative meniscus tears. They were followed for two years.
The authors demonstrated that in patients with knee osteoarthritis, arthroscopic knee surgery with meniscectomy is associated with a 3 fold increase in the risk for future knee replacement surgery.
Comment: Don’t do it if you can avoid it. The meniscus serves of function. It helps to cushion the knee. Any meniscus tissue should be preserved.
Got a kid or grandkid playing soccer, here’s some news…
Study Reveals Increase In Soccer-Related Injuries, Concussions
Lindsey Tanner writing for the AP reported research has found an increase in soccer-related injuries among kids in the US being sent to emergency departments. The trend is “driven in part by young players with concussions seeking urgent medical care.” The findings were based on 25 years of data and found that the overall rate of injuries has “more than doubled to 220 per 10,000 players in 2013, from 106 per 10,000 players in 1990.”
Comment: One of my sons when he was playing soccer had 2 concussions. This is a serious issue.
And your surgeon says you need surgery… maybe not… next
Meniscal Tears May Not Need Surgery
Jack Cush reporting in RheumNow cited a study published in the British Medical Journal examines whether knee surgery or conservative medical management benefits those with degenerative meniscal tears. Patients with knee pain from a degenerative meniscal tear were randomized to either arthroscopic surgery (followed by daily exercises at home) or physical therapy (neuromuscular and strength exercises) two to three times a week for 12 weeks.
Over the next 2 years both groups improved. Muscle strength had improved more, on average, in the physical therapy group at the three-month checkup, but at the final two-year checkup, there was essentially no difference between the surgery and therapy groups, including in pain, ability to function in sports and recreation activities, and quality of life. The researchers noted that 19 percent of the therapy group opted to have surgery at some point but had achieved “no additional benefit” by the end of the study.
Conservative exercise therapy was equal to arthroscopic intervention overall, but also showed positive effects over surgery short-term muscle strength. Clinicians should consider conservative management and physical therapy in middle-aged patients with degenerative meniscal tears.
Comment: Degenerative meniscus tears are secondary to the arthritis. Surgery is not generally warranted.
Another promising treatment for osteoarthritis knee pain
Radiofrequency Neurotomy Efficient In Knee Osteoarthritis
Reported in Healthday, this item… For patients with chronic knee osteoarthritis (OA) pain, radiofrequency (RF) neurotomy of genicular nerves is safe and efficient, according to a study published in the International Journal of Rheumatic Diseases.
Sinem Sari, M.D., from Adnan Menderes University in Aydin, Turkey, and colleagues compared the efficacy of intra-articular injection of anesthetic and steroid and RF neurotomy of genicular nerves in 73 patients with chronic knee OA pain. Patients were randomized to the injection group or to the RF neurotomy group.
The researchers observed no statistically significant differences between the groups in terms of pain. “This study demonstrated that genicular nerve RF neurotomy is a safe and efficient treatment modality and provides functional improvement along with an analgesia in patients with chronic knee OA,” the author said.
Low-dose spironolactone seen as safe, effective treatment for patients with OA-related knee effusion
Reported in Healio… “Low dose spironolactone is a safe, effective and noninvasive treatment for osteoarthritis-related effusion. It is effective in mild and moderate cases and, to a lesser extent, in severe cases,” Sarah Ohrndorf, MD, specialist in internal medicine/rheumatology in the Department of Rheumatology and Clinical Immunology at Charité University Hospital in Berlin.
Researchers categorized 200 patients with unilateral knee effusion related to osteoarthritis (OA) into four groups with 50 patients in group 1 receiving spironolactone for 2 weeks, 50 patients in group 2 receiving ibuprofen for 2 weeks, 50 patients in group 3 using cold compresses twice daily for 2 weeks and 50 patients in group 4 receiving placebo for 2 weeks. Group 1 outperformed all other groups.