It is the most common orthopedic procedure performed in the United States each year. Arthroscopic surgery on the meniscus takes place about 700,000 times annually. The meniscus is triangular-shaped cartilage in the knee joint that serves as a shock absorber.
"On this MRI it should look all black and if you look here in the back you see the vertical white line and that represents a tear. So she tore her ACL and her meniscus," said Dr. Nate Endres, an orthopedic surgeon at Fletcher Allen Health Care.
Endres calls this an acute tear from a traumatic injury to a young athlete. He says she is a good candidate for surgery. But a new study out of Finland is now lending support to previous studies that show surgery on degenerative meniscus tears in older patients has little or no benefit. They compared patients who received actual surgery and others who unknowingly had a sham procedure.
"And they followed those two groups over time and by and large the results were the same and their conclusion was that surgery for degenerative tears may not really be that effective. And I don't disagree with that at all," Endres.
Endres emphasizes that no two knees are alike, but he says a conservative approach to those wear and tear injuries to the meniscus is best, usually with six to eight weeks of non-invasive treatment.
"It's now been shown in multiple studies that patients can be now be treated very effectively with non-surgical treatment, which includes simply just time-- waiting, weight loss, physical therapy, anti-inflammatory medication, sometimes bracing, sometimes even injections like corticosteroid injections. So, I would say surgery is definitely the last option for that particular problem," Endres said.
A problem that afflicts hundreds of thousands of people nationwide, some who will benefit from surgery, and clearly, some who won't.
That study was recently published in the New England Journal of Medicine.
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