Meniscal tears are one of the most common types of knee injuries affecting people, particularly athletes. The meniscus is a C-shaped disc of cartilage in the knees that acts as a cushion between the thighbone and the shinbone. It keeps the knee steady by balancing the total body weight across the knee.
Meniscal tears can occur during activities that put direct pressure on or rotate the knee joint. A sudden twist or turn, heavy lifting or deep squatting can also cause this injury. The common symptoms associated with this condition include knee pain, a popping sensation around joints, swelling and stiffness, and difficulty in knee movement. Sport athletes are at high risk of this injury. The treatment options for the condition can vary from exercises (to strengthen the muscles) to surgery. The type of treatment recommended would vary from person to person depending on the severity of the injury and other factors.
A new study has reported that a common type of knee surgery to repair meniscal tears may potentially increase the risk of osteoarthritis and cartilage loss in some patients. The study results presented at the annual meeting of the Radiological Society of North America (RSNA, 2014) show that the decision for knee surgery requires careful consideration so as to avoid accelerated disease onset.
As part of the study, the researchers analyzed data from the Osteoarthritis Initiative – a large study that measured the incidence and progression of knee osteoarthritis. The participants were of average age 60.2 years and had a body mass index (BMI) of 28.3 (predominantly overweight). More than two-thirds of the patients were women.
The researchers evaluated Magnetic Resonance Imaging (MRI) exams of 355 knees that developed osteoarthritis during a 5-year period, and a control group matched in terms of age, gender, arthritic severity in both knees and BMI. Out of all the knees, 31 underwent surgery before the year of arthritis diagnosis and 280 knees that showed signs of meniscal damage but did not undergo surgery. The analysis also included control cases with no meniscal damage. The risk of developing arthritis and cartilage loss for the different groups were also assessed. The key findings of the study are as follows:
- Patients without any specific symptoms of knee osteoarthritis who underwent meniscal surgery suffered increased risk for developing osteoarthritis and cartilage loss in the following year when compared to those who did not have surgery, regardless of the presence or absence of a meniscal tear the year before.
- All 31 knees that were operated for meniscal tear repair developed arthritis within a year when compared to165 (59%) of the knees with this damage that did not have surgery.
- Nearly 81% of knees that had meniscal surgery suffered cartilage loss when compared with 40% of knees with meniscal damage that did not have surgery.
The researchers recommend conservative treatment modalities such as physical therapy as an alternative to surgery. For instance, a physical therapy exercise program offered by a reliable healthcare center is designed to maintain and improve muscle strength and range of motion. Other proven treatments offered to treat symptoms of knee pain include ice and heat application, TENS (Transcutaneous Electrical Nerve Stimulation) and non-steroidal anti-inflammatory medications.