Weighing up the risks and benefits

At the 2014 Annual Meeting of Radiological Society of North America an important study was published.

354 patients with meniscus tears of the knee who did not have surgery were compared with 354 knees that had been surgically repaired.

Without any intervention the risk of arthritis increases if there is damage to the meniscus even if surgery is not undertaken but markedly increased for knees that had surgery.

During the previous year, about 4% of the patients in the study underwent knee surgery. All of the 31 knees that showed evidence of osteoarthritis came from the group of patients who had undergone meniscus surgery (31 of 354 patients). Of the 354 patients who did not have surgery for their meniscus tears, none developed osteoarthritis.

This study only focused on knee structure and not pain or other symptoms.

Comment:
There are times when surgery is needed to improve symptoms especially when there is a locking sensation or a sensation that the knee will give way”.

This study highlights the need to carefully evaluate the benefit versus the risk of surgery.