HealthDay News – For adults with a degenerative medial meniscus tear, arthroscopic partial meniscectomy (APM) has no additional benefit over sham surgery for relief of knee catching or occasional locking, according to a study published online Feb. 9 in the Annals of Internal Medicine.

Raine Sihvonen, MD, PhD, from Hatanpää Hospital and the University of Tampere in Finland, and colleagues examined whether APM improves mechanical symptoms better than sham surgery for adults aged 35 to 65 years with a degenerative medial meniscus tear and no knee osteoarthritis. Data were included for 70 patients randomized to APM and 76 randomized to sham surgery.

The researchers found that 46% of the APM group and 49% of the sham surgery group reported catching or locking before surgery. At any follow-up occasion, the corresponding figures were 49 % and 43% respectively (risk difference 0.03). The risk difference was 0.07 in the subgroup of 69 patients with preoperative catching or locking.

“Resection of a torn meniscus has no added benefit over sham surgery to relieve knee catching or occasional locking,” the authors write. “These findings question whether these symptoms are caused by a degenerative meniscus tear, and prompt caution in using patients’ self-report of these symptoms as an indication for APM.”


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Summary and Clinical Applicability

In the absence of OA, APM did not appear to be any more efficacious than nonoperative therapy at reducing the specific symptoms of knee locking and catching. 

The study was limited by the post hoc collection of data and by the self-reporting of mechanical knee symptoms by patients.  The results of this study may also only be applicable to patients with degenerative medial meniscal tears who experience the specific symptoms of knee catching and locking; therefore, generalization to other symptoms associated with meniscal tears would need further studies for confirmation. 

Reference

Sihvonen R, Englund M, Turkiewicz A, Järvinen TL, for the Finnish Degenerative Meniscal Lesion Study Group. Mechanical Symptoms and Arthroscopic Partial Meniscectomy in Patients With Degenerative Meniscus Tear: A Secondary Analysis of a Randomized Trial. Ann Intern Med. [Epub ahead of print 9 February 2016] doi:10.7326/M15-0899