Meniscal Tears in OA: Arthroscopy No Help
Written by Editor   
Friday, April 15, 2016 01:00 PM

Among patients who have meniscal damage complicated by knee osteoarthritis (OA), arthroscopy did not decrease or delay the likelihood of eventually having knee replacement, a researcher has reported.

In a large cohort of patients with knee OA and meniscal damage, 4,883 had knee arthroscopy and 2,143 had physical therapy alone. Over the course of more than 10 years, almost 1,400 patients in the arthroscopy group underwent knee replacement surgery compared with 488 in the physical therapy group. "Over time, patients who had knee arthroscopy were 30% more likely to undergo knee replacement than those who had physical therapy alone." 

"A lot of orthopedists tell patients that arthroscopy will buy you time, staving off the need for total knee replacement, but we found that was not the case," the study author said.

"Our data show that knee arthroscopy in the milieu of knee OA with a meniscal tear did not stave off knee arthroplasty or buy patients time."

"The American Board of Internal Medicine recently put forth a campaign called Choosing Wisely to encourage physicians and patients to engage in conversations about reducing the overuse of tests and procedures. The American Academy of Orthopaedic Surgeons initially suggested limiting patient use of over the counter nutraceuticals such as glucosamine, which are often recommended for knee pain," he said.

Patients presenting with knee pain typically are evaluated for both OA and meniscal damage, and to relieve pain and delay the need for more invasive knee surgery, the meniscal damage is often treated with arthroscopy even in mild or moderate OA is present. However, recent randomized studies found no greater pain relief or functional improvement with arthroscopy compared with physical therapy alone.