Friday, 25 May 2018

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Limited Utility of Arthroscopic Meniscal Surgery

JAMA Surgery reports that arthroscopic partial meniscectomy (APM) is still one of the most common surgeries performed, despite evidence from large trials (eg, FIDELITY study) showing that APM is no more effective than exercise and physical therapy, especially in adults over age 65 years. (Citation source: https://buff.ly/2FN78wL)

The current report was an analysis of Medicare claims data involving 12,504 orthopedic surgeons and 121,624 knee arthroscopies performed in 2016.  Overall, about two-thirds of the operations involved this procedure alone, regardless of whether surgeons did a low or high volume of knee operations, the study found.

Among high-volume surgeons, 13 percent never did additional repair work when they performed arthroscopic partial meniscectomies, while 7 percent never performed this procedure on its own.

The authors conclude that patients with osteoarthritis and degenerative meniscal tears  may benefit just as much from physical therapy, exercise, weight loss and education.

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