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Effects and Benefits of Meniscectomy in an Arthritic Knee

Patients with both osteoarthritis (OA) and a torn meniscus in one area of the knee are faced with a new problem. Will the OA get worse if the meniscus is removed? What if the painful symptoms are really from the OA? Will taking the meniscus out make any difference?

Researchers at the National Health Service in England set out to answer these questions. Doctors searched their data banks to find cases of both knee OA and a torn meniscus. Over eight years, 3,000 patients had arthroscopic knee surgery. Of those 3,000, researchers found 126 patients who had both problems. This group was compared to a smaller control group of 13 patients. The control group had severe arthritis with exposed bone, but the meniscus was fine. Researchers compared factors including pain, effect of symptoms on work or recreation, and amount of medication used to control symptoms.

The group with severe OA and a torn meniscus had arthroscopic surgery to remove the cartilage. The smaller group just had any frayed cartilage smoothed out and the area cleansed. Everyone was rechecked and examined one year later. Most patients were followed for four years.

The authors report that removing part of the meniscus in patients with severe OA doesn't speed up damage from the arthritis. These patients' symptoms improve in the short term. In fact, patients in the control group ended up having more joint replacements than the group with meniscus problems. On the other hand, the meniscectomy didn't improve the OA symptoms.

In patients with both severe OA and a torn meniscus, doctors can't tell which problem is causing the pain until after the operation. According to this study, it's okay to remove the meniscus. It doesn't seem to make the OA worsen later, and the patient gets relief of symptoms right now.

References: Eyiyemi O. Pearse, MA, MRCS, and David M. Craig, FRCS. Partial Meniscectomy in the Presence of Severe Osteoarthritis Does Not Hasten the Symptomatic Progression of Osteoarthritis. In Arthroscopy. November 2003. Vol. 19. No. 9. Pp. 963-968.

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