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Knee surgery and the rate of cartilage loss…

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meniscus-surgery

I was reviewing some old research files and came across this publication about the rate of knee cartilage loss after partial menisectomy.  Basically, it followed a partial menisectopmy knee surgery group (this is the surgery where part of the torn meniscus is removed) versus a normal control group for a little over two years.  The knee surgery group lost cartilage at about twice the rate of the normal group.  This makes sense to me, as if we remove some of the cartilage cushioning of the knee (meniscus), then the remaining cartilage gets more wear and tear.  This fits with multiple studies now showing that arthroscopic  debridement knee surgeries are no better than placebo. The upshot of all of this is that since we know now that about 60% of meniscus tears are asymptomatic (cause no symptoms, despite being seen on MRI), why are we surgically removing pieces of meniscus if this only increases the rate at which the remaining cartilage is worn away?  We have seen evidence on MRI in our patients treated with stem cell injections of improvement in the appearance of the meniscus, as well as increased height in the meniscus.  Is there a better way?

Category: Knee

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