Mechanical Symptoms and Arthroscopic Partial Meniscectomy in Patients With Degenerative Meniscus Tear: A Secondary...

Area of Science:

• Orthopedic Surgery
• Knee Biomechanics
• Degenerative Joint Disease

Background:

• Arthroscopic partial meniscectomy (APM) is a common procedure for degenerative meniscus tears.
• Previous evidence suggests APM offers no benefit over conservative treatment for these tears.
• However, mechanical symptoms like knee catching or locking might indicate a potential benefit from APM.

Purpose of the Study:

• To evaluate if APM provides superior relief of mechanical symptoms compared to sham surgery in patients with degenerative meniscus tears.
• To investigate the efficacy of APM specifically for knee catching and locking sensations.

Main Methods:

• A randomized, patient- and outcome assessor-blinded, sham surgery-controlled, multicenter trial.
• Adults aged 35-65 with degenerative medial meniscus tears and no osteoarthritis were included.
• Participants underwent either APM or sham surgery, with outcomes assessed at 2, 6, and 12 months post-procedure.

Main Results:

• No significant difference in the occurrence of catching or locking symptoms was observed between the APM and sham surgery groups at any follow-up point (risk difference: 0.03; 95% CI, -0.06 to 0.12).
• In a subgroup analysis of patients with preoperative mechanical symptoms, APM still showed no significant advantage over sham surgery (risk difference: 0.07; 95% CI, -0.08 to 0.22).
• The study was limited by post-hoc analyses and generalizability primarily to knee catching and occasional locking.

Conclusions:

• Resection of a torn meniscus via APM does not offer added benefit over sham surgery for relieving knee catching or occasional locking.
• These findings challenge the assumption that mechanical symptoms are directly caused by degenerative meniscus tears.
• Caution is advised when using patient-reported mechanical symptoms as the sole indication for performing APM.