Chronic knee pain can be quite a frustrating injury to deal with.

Sometimes, people go to surgeons, and they recommend a menisectomy after doing an MRI.

But this is often more a process of looking for something, rather than finding something.

Often times those MRI findings are benign findings that don’t mean anything.

Furthermore, who ever you go to is going to want to do what they’re good at. Meaning if you go to a massage therapist, they’ll tell you that your muscles are tight and you need manual therapy. If you go to a physical therapist they’ll tell you that your muscles are weak and need to be strengthened. If you go to a surgeon, they’re going to tell you that you need surgery…

But I digress

The 2 Things to Know

1. no better than placebo surgery

There was a profound study that found no difference between a menisectomy and a placebo surgery.

Yes, no better than placebo surgery.

“In this trial involving patients without knee osteoarthritis but with symptoms of a degenerative medial meniscus tear, the outcomes after arthroscopic partial meniscectomy were no better than those after a sham surgical procedure.”

This study should have ended this surgery alone.

2. will lead you to a knee replacement

The other studies show that this surgery will cause an increased risk of needing a knee replacement in the near future.

“Osteoarthritis patients who underwent menisectomy for the meniscal injury had higher incidence of total knee replacement up to 10 years of follow-up than the non-operated group. The greater knee replacement utilization observed in patients undergoing menisectomy merits caution when treating OA patients with meniscal injury.”

Is this because surgery disrupts the joint’s homeostasis, leading to significant post op weakness that isn’t always corrected, removes the “cushion” of the knee (meniscus), alters the dynamic interplay of the tissue, or leads to disappointment and further patient inquiry for simple solutions?

Regardless of the reason, it’s clear there is an association.

Summary

Sometimes a meniscectomy is necessary. Maybe the knee is locking, or it’s a large acute tear.

But often times it’s not. Cleaning up the mechanics of the lower extremity and strengthening the quads and hamstrings can make a huge impact.

Dry needling and manual therapy are also very helpful.

Comment below if you have any questions.