Meniscal Knee Surgery May Accelerate Arthritis and Cartilage Loss

Frank W. Roemer, MD Associate Professor of Radiology Co-Director, Quantitative Imaging Center (QIC), Department of Radiology Boston University School of Medicine Boston MA 02118MedicalResearch.com Interview with:
Frank W. Roemer, MD

Associate Professor of Radiology
Co-Director, Quantitative Imaging Center (QIC), Department of Radiology Boston University School of Medicine
and Associate Professor of Radiology, University of Erlangen-Nuremberg, Germany

Medical Research: What is the background for this study? What are the main findings?

Dr. Roemer: Meniscal surgery is one of the most common orthopedic procedures performed in order to alleviate pain and improve joint function. However, increasing evidence is emerging that suggests that meniscal resection is detrimental for knee joint preservation including accelerated rates of OA and joint deterioration defined as cartilage loss. Our study focuses on disease onset and shows that structural damage due to surgery might also be observed in these early stages of disease. In light of this the indications for performing meniscal surgery might need to be defined more stringently as is the case today in order to preserve joint structure in the long term.

Medical Research: What should clinicians and patients take away from your report?

Dr. Roemer: In light of the findings that we are presenting focusing on structural outcomes and two additional studies that have been presented in the New England Journal of Medicine last year (Katz JN et al. N Engl J Med. 2013;368(18):1675-84. Sihvonen R et al. N Engl J Med 2013;369(26):2515-24) focusing on clinical outcomes showing no superiority for patients treated with surgery compared to a conservative regimen or for partial meniscal resection compared to sham surgery, the indications for meniscal surgery might need to be discussed more carefully in order to avoid accelerated knee joint degeneration.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Roemer: Additional case-control studies are needed to evaluate whether meniscal surgery has a negative effect on joint structure in patients without degenerative joint disease taking into account the potential benefit that patients might have clinically, i.e. improvement of their symptoms.

Citation:
RSNA 2014  abstract discussing:

Common Knee Surgery May Lead to Arthritis and Cartilage Loss

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