Review: Surgery Doesn't Benefit Age-Related Meniscal Tears
Middle-aged patients with mild or no osteoarthritis may not benefit from arthroscopic knee surgery
TUESDAY, Aug. 26, 2014 (HealthDay News) -- Evidence suggests that arthroscopic surgery does not benefit middle-aged patients with degenerative meniscal tears, according to research published online Aug. 25 in CMAJ, the journal of the Canadian Medical Association.
Moin Khan, M.D., of McMaster University in Hamilton, Canada, and colleagues conducted a systematic review of the literature and performed a meta-analysis using data from seven randomized, controlled trials, involving 805 patients. The authors sought to assess the efficacy of arthroscopic meniscal debridement in patients with mild or no osteoarthritis.
The researchers found that, compared with patients with knee pain undergoing sham operative treatments or nonoperative treatments, those undergoing arthroscopic surgery did not have a significant or minimally important difference (MID) in long-term functional outcomes (standardized mean difference [SMD], 0.07; 95 percent confidence interval [CI], −0.10 to 0.23). Short-term functional outcomes differed significantly between the groups but did not exceed the threshold for MID (SMD, 0.25; 95 percent CI, 0.02 to 0.48). Compared with patients receiving the other treatments, those receiving arthroscopic surgery did not have significant improvement in short-term pain scores (mean difference [MD], 0.20; 95 percent CI, −0.67 to 0.26) or long-term pain scores (MD, −0.06; 95 percent CI, −0.28 to 0.15).
"With limited evidence supporting arthroscopic meniscal debridement for degenerative meniscal tears in the setting of mild or no concomitant osteoarthritis, an initial trial of nonoperative interventions should play a large role for middle-aged patients," the authors write.
One author disclosed financial ties to pharmaceutical and medical device companies.