Getting Meniscus Trimmed? Think Twice.

Choosing Wisely is an initiative launched by the American Board of Internal Medicine encouraging patients and physicians to have conversations about medical tests and treatments that are common but may lack sufficient scientific evidence. National medical organizations were asked to identify tests or procedures that are common in their specialty but whose necessity should be questioned or discussed.

One that is near and dear to our heart at Winning Health is one that was put forth by an organization that both Dr McMarlin and Dr Upshaw are involved with - the American Medical Society for Sports Medicine (AMSSM). Do you really need to have your meniscus - which serves as a bumper cushion for the knee - removed? On April 5, 2014, AMSSM submitted the following recommendation :”Avoid recommending knee arthroscopy as initial/management for patients with degenerative meniscal tears and no mechanical symptoms.

Degenerative meniscal tears may respond to non-operative treatments such as exercise to improve muscle strength, endurance and flexibility. Other treatment options include mild analgesics, anti-inflammatory medication, activity modification or corticosteroid injection.”(Choosewisely.org- accessed 12/27/2019)

Even more timely, the January 2020 issue of the British Journal of Sports Medicine published an article by Pihl and colleagues looking at whether certain subtypes of patients (eg. younger, those with mechanical symptoms, etc) necessarily benefited from meniscectomy. A year post-operatively from a partial meniscectomy, the authors found that it was not as easy to predict which subgroups would benefit from surgery as once thought. (Pihl K et al. Wild goose chase - no predictable patient subgroups benefit from meniscal surgery: patient- reported outcomes of 641 patients one year later. BMJ. Jan 2020: 54: 13-22.)

Having knee pain? Concerned that your mensicus is causing problems? Before you remove your knees’ bumper cushion, come talk to us at Winning Health Sports Medicine to explore nonsurgical options first.