Considering meniscus surgery? Read the 3 reasons why you shouldn’t get meniscus surgery and find out how physical therapy can help.
Knee injuries suck. Knee surgeries suck even worse. They affect a whole lot of things that we often take for granted like going up and down stairs, playing a sport like basketball, tennis, soccer, or golf. So, you have to know your options when it comes to knee pain. Most surgeons recommend getting your knee cleaned out or trimmed up which involves a procedure called arthroscopic meniscectomy. While common, this article is here to help determine whether or not you even need the surgery. Let’s take a look at the research.
1. Meniscectomy- No Better than Placebo Surgery
Back in 2013, a group of researchers1 conducted a high-quality study on patients from 35-65 years of age who had a degenerative meniscus tear and no arthritis. The study then split the participants into two groups: group A had a partial meniscectomy and Group B had an arthroscopic procedure performed without changing their meniscus or other structures. The results? No significant difference was found between meniscus surgery versus placebo surgery. Why this happened? There are multiple reasons, but the brain is powerful and belief in the effectiveness of an intervention can lead to just as many positive results as the actual reasons for why the treatment works. Either way, if you have a degenerative tear (meaning you had knee pain come on gradually and without a specific event that caused your knee injury), you may want to reconsider a meniscectomy procedure and try out conservative options like Physical Therapy.
2. Meniscectomy Procedures Lead to an Early Onset of Arthritis
Your meniscus acts as a shock absorber, load manager, and helps distribute fluid throughout your joint. Once all or a part is removed, your joint is subject to the strain your meniscus was designed to manage. It is no secret among many studies of long-term outcomes that the development of osteoarthritis is correlated with meniscectomy procedures2,3. It’s unfortunate, but true. Some studies even show a greater effect to females and older individuals. Ultimately, the more meniscus you have removed equates to the higher risk of osteoarthritis.
3. Conservative Rehab Can Be Just As Effective
Lastly, you should know that there are other options available other than surgeries. Yes, I am going to push for Physical Therapy because it is a great option to pursue. In fact, more studies are finding that physical therapy is just as effective as arthroscopic surgery for degenerative meniscal tears in individuals 35-40 and older4,5,6. At the very least, physical therapy should be pursued with a dedication to the rehab program for 3-6 months before considering surgical options. Especially knowing in the previous point that arthritis can be accelerated with a “clean up” procedure. I always tell my patients, throw every conservative option that you can try before getting a meniscectomy.
Now, does this article mean that I am anti-meniscus surgery? The answer is no. If you have had a traumatic injury like a sports injury and are young, most research says that surgery is still a good option. Also, if your meniscus can undergo a repair (meaning the surgeon stitches it back up), then that should be strongly considered if your surgeon thinks it is appropriate. Just understand that the recovery during a meniscus repair is very different than a meniscectomy and typically involves using crutches for 4-6 weeks without being able to put weight on your operated leg. Ultimately, I push hard for conservative rehab in initial months following an injury or onset of pain. If you still have symptoms or your condition hasn’t improved and you have tried every possible conservative option available, then surgery will likely be the route you will need.