Knee surgery may worsen arthritis symptoms

Knee osteoarthritis patients may not benefit from a common surgery, the partial removal of meniscus cartilage, according to new research from Finland, and may actually worsen their long-term knee health.

Study participants who underwent meniscectomies had poorer outcomes over 10 years than those who had sham surgeries, with more knee pain, less knee use, and more osteoarthritis.

Meniscus tears are common in older people with osteoarthritis, but it’s now thought that these tears may not be the main cause of pain.

The meniscus is a piece of cartilage in the knee that provides shock absorption between the shin bone and the thigh bone, and can tear due to a sudden twist or with age.

For many years, doctors assumed that meniscus tears were the source of knee pain, but this may not be the case, according to orthopedic surgeon Clint Soppe, MD.

Soppe noted that knee pain can be due to a meniscus tear or osteoarthritis, as both conditions often occur together in older people.

The study’s senior investigator, Teppo L.N. Järvinen, MD, PhD, said that there is now a substantial body of evidence suggesting that they may have been targeting the wrong problem by performing meniscectomies.

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Järvinen added that meniscal tears are common in people with no symptoms, which suggests that the tear itself may not be the main driver of pain.

Paul Arciero, DPE, of the Health and Human Physiological Sciences Department at Skidmore College, agreed that widely used treatments can persist despite limited evidence, and may even cause harm.

Arciero noted that many people who have undergone arthroscopic partial meniscectomy report worsening pain and mobility over time.

Soppe cited advances in our understanding of chronic pain conditions, including the role of cell mediators such as interleukin inhibitors, cytokines, and TNF-alpha.

He recommended giving knee pain time to resolve on its own, and using symptoms management techniques such as anti-inflammatory pills, physical therapy, and rest, which can help with natural discomfort relief.

Soppe also suggested that cycling, injection treatments, and other modalities may be helpful in managing knee pain.

He still performs meniscectomies, but only in specific circumstances, such as when a meniscus tear is displaced and causing other issues.

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Arciero noted that there may still be a place for meniscus repair in certain cases, such as acute traumatic injury to the knee joint.

However, in most cases of routine meniscus tears and pain, alternative treatments may be more effective in the long term.

The study’s findings have implications for the treatment of knee osteoarthritis, and highlight the need for further research into the effectiveness of different treatments.

The osteoarthritis community may need to re-evaluate the role of meniscectomies in the treatment of knee pain.

In terms of numbers, the study found that 93% of participants who underwent meniscectomies had osteoarthritis at the 10-year follow-up, compared to 79% of those who had sham surgeries.

The study’s results are likely to be of interest to the people who undergo knee replacement surgery each year, which is around 2.1 million in the US.

As the population ages, the number of people with knee osteoarthritis is likely to increase, making it essential to find effective treatments for this condition, and researchers on the scene are working to develop new approaches.