Treatment options for the symptomatic post-meniscectomy knee.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomaterials Science

Background:

• Meniscus deficiency, often resulting from meniscectomy, is linked to early-onset knee osteoarthritis (OA).
• A subset of patients experience post-meniscectomy syndrome, characterized by persistent knee pain and effusions.
• Current evidence for non-surgical management of post-meniscectomy pain is limited.

Purpose of the Study:

• To review current evidence on managing the symptomatic meniscus-deficient knee.
• To explore various treatment strategies for post-meniscectomy knee pain and osteoarthritis.

Main Methods:

• Literature review of natural history, symptom origins, and management strategies.
• Evaluation of non-surgical options, meniscus scaffolds, meniscus allograft transplantation (MAT), cartilage repair, osteotomies, meniscus prosthesis, and joint replacements.

Main Results:

• Meniscus scaffolds offer mid-term pain relief for segmental deficiency, but joint preservation effects are unclear.
• Meniscus allograft transplantation (MAT) shows durability for sub/total deficiency and may slow OA progression.
• Osteotomies and joint replacements are indicated for advanced stages of post-meniscectomy OA and structural changes.

Conclusions:

• Post-meniscectomy pain and OA are common sequelae of meniscus resection.
• Treatment efficacy varies: non-surgical for short-term, scaffolds for mid-term, and MAT for long-term pain relief.
• Advanced knee conditions necessitate osteotomies or joint replacements.