New Trends in Treating Knee InjuriesThere's a new trend in treating meniscus tears of the knee: repair it or leave it, but, whenever possible, don't remove it. Taking the cartilage out of the knee leads to higher rates of future knee damage and more surgery.
In this study 332 patients had an anterior cruciate ligament (ACL) tear along with damage to the lateral meniscus. The lateral meniscus is the cartilage along the outside edge of the knee joint. Only the ACL was repaired. The surgeons left the lateral meniscus alone. In some cases the meniscus was shaved or smoothed out, but it was not removed.
Every year after the operation, doctors sent the patients a survey to fill out. Patients came back to the clinic at two, five, and 10 years after surgery for examination and X-rays. How did these patients do years later?
They had excellent results! Only three percent had to go back for surgery to repair the torn meniscus. Almost all (96 percent) had normal knee function. Only a little over five percent had any joint changes. Even so, in these cases, the joint space was only narrowed mildly.
This study shows that a damaged lateral meniscus doesn't always have to be dealt with at the time of knee surgery for a torn ACL tear. Not all lateral meniscus tears have to be stitched up during surgery for the ACL. Some do fine either being left alone or by simply roughing up the damaged spot. This is true for a variety of small tears in the lateral meniscus. The long-term results show that the these types of tears have at least some ability to heal.
K. Donald Shelbourne, MD, and John Heinrich, MD. The Long-term Evaluation of Lateral Meniscus Tears Left In Situ at the Time of Anterior Cruciate Ligament Reconstruction. In Arthroscopy. April 2004. Vol. 20. No. 4. Pp. 346-351.
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