In a Finnish study appearing in the December 26, 2013 edition of The New England Journal of Medicine, the researchers reported that the outcomes for study participants who had arthroscopic partial meniscectomy were no better than for study participants who had a “sham” surgical procedure. All of the study participants had symptoms of degenerative medical meniscus tear but did not have knee osteoarthritis.
Degenerative meniscal tears are the most common cause of knee pain, swelling, and loss of function. The most common orthopedic procedure to treat meniscal tears is a partial arthroscopic meniscectomy. Improvements have been noted in patients both after arthroscopy and with conservative treatment, but there was no study prior to the Finnish study comparing the improvements associated with arthroscopy versus conservative treatment.
About one-half of the study participants had an actual arthroscopic meniscectomy (using an arthroscope and specially designed instruments to surgically remove or repair the torn segment of the meniscus) and the remaining participants had sham surgery in which incisions were made without undertaking meniscus repair.
The Finnish study involved 146 participants that started in October 2007 and was completed in March 2013. To participate in the study, the individuals had to be between 35 and 65 years old; they had to have pain located on the medial joint line of the knee that had persisted for at least 3 months; the pain can be provoked by palpation or compression of the joint line or a positive McMurray sign; the tear of the medial meniscus had been confirmed on an MRI; and, the degenerative rupture of the medial meniscus was confirmed during arthroscopy.
Individuals were excluded from participating in the study if they had acute, trauma-induced onset of symptoms; they had locking or painful snapping of the knee joint; they had had a surgical procedure on the affected knee; they had osteoarthritis of the medial compartment of the knee; they had osteoarthritis as identified in x-rays of the knee; they had had an acute fracture of the knee within the previous year; they had decreased range of motion of the knee; they had instability of the knee; an MRI showed a tumor or any other complaint requiring surgical or other means of treatment; or, arthroscopic assessment showed anything other than a degenerative tear of the medial meniscus requiring surgical intervention.
The study’s researchers concluded, “In this trial involving patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after arthroscopic partial meniscectomy were no better than those after a sham surgical procedure.”
If you, a family member, or a friend had a bad outcome after arthroscopic surgery, you should promptly contact a local medical malpractice attorney in your U.S. state who may investigate whether medical negligence was a cause of your bad result and who may represent you in a medical malpractice case, if appropriate.
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