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.
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.
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.
Did you know your nose could help your knees. Find out how next…
Aching Knee? Surgeons Pioneer Groundbreaking New Operation Taking Tissue From The NOSE To Grow Cartilage That May Be Due To Osteoarthritis!
Roger Dobson writing for the Daily Mail reported surgeons are taking tissue from the nose to grow cartilage to fix knee-joint pain.
The operation sees cartilage harvested from the nose, which is then used to grow patches of tissue to be transplanted on to knee joints.
The procedure is regarded as particularly beneficial for osteoarthritis patients, or those at risk of the joint disease, and doctors carrying out the operation say it could help thousands of people.
The most widely used procedure to repair the injury involves trimming any remaining damaged tissue and drilling holes in the bone beneath the defect to trigger bleeding and scar tissue that, it is hoped, can work as a substitute tissue.
But according to the NHS, results are variable, with studies suggesting that it offers only short-term benefits and does not lead to the formation of new cartilage.
Comment: The procedure is a bit risky for only short term relief but maybe it will improve.
Wow… a new development that may help erase osteoarthritis… next
Unique Gel Combats Inflammation
Jessa Gamble writing for the Atlantic reported researchers have created a gel that can attach to inflammation sites and slowly deliver drugs to combat a wide variety of ailments—ulcerative colitis, arthritis and mucositis, to name a few. Inflammation is part of the body’s immune response, bringing extra blood to an injured area, but in cases of chronic inflammation, the heat, pain, and swelling become a problem. Developed at the Laboratory for Accelerated Medical Innovation at the Brigham and Women’s Hospital, the hydrogel—a solid material with high water content—can carry a combination of drugs, and matches its drug release to the level of inflammation around it.
When the gel is injected into the joint of an arthritis patient, for example, it will only release its anti-inflammatory payload when the patient is experiencing a flare, a spike in pain and swelling. When it encounters healthy tissue, it stays intact and does not release its payload.
“There are lots of enzymes present in inflammation that can degrade the gel,” explains Jeff Karp, the principal investigator. That breakdown of the gel releases the drug it carries.