Surgery: Is It Always the Right Option for Meniscal Repair?
There is a certain trend in socially held views on medicine that surgery will almost always fix the problem in the fastest and most complete manner. It is important to remember that medicine is a science, and doctors often work with incomplete information and inadequate tools. To serve as a reminder, we will take a quick look at surgery done to repair the meniscus in the knee.
Why Is the Meniscus Important?
The knee is one of the most important parts of the body. The complex structure of bone and flesh makes it possible for humans to move, but as with machinery, having more moving parts tends to mean having a higher chance of complication. The meniscus serves to protect and shape the knee so as to possess more balance. Due to meniscus tears often occurring in tandem with ligament tears, they usually mean an inability to walk at just the moderate severity level.
Meniscus Surgery Methods
The first recorded surgery on the meniscus occurred in the 19th century, but the technique has come quite a way since that time. Past techniques included open knee surgery that left scars from the middle of the thigh to several inches below the knee. Before that, the entire meniscus was simply removed. Now, small incisions, optical technology, and a skilled surgeon can allow it to be done with remarkably less injury to the area than before the arthroscopic technique was developed.
Study on Meniscus Repair Surgeries
Looking back through the records of a skilled orthopedic surgeon, a study looked at the success rate of meniscal surgery performed properly by a respected doctor [1]. The analysis of the data eventually led to some interesting conclusions, though some were expected. Most importantly, it noted that the people most prone to needing secondary surgery had larger initial tears, had tears in the inner “red-white” area of the meniscus, had a rim length of over 4mm, and went through isolated meniscal repairs. Of the sample, 12% needed secondary surgery. Another study showed 22% of the sample needing the secondary repairs [2].
When reviewing these facts, it is also important to keep in mind that surgery is always going to take a toll on the body, even with improved techniques and if you fit the ideal patient profile. Also, remember that no medical procedure is going to have 100% success rates, and in some cases surgery may be the only realistic option.
Alternative Methods to Surgery
After looking at the information, you may be wondering if surgery is the right choice for you. If you fall outside the range of candidates determined by the study to be more likely to have successful surgery, then you definitely want to consider options like physical therapy and rehabilitation. Serious tears may be impossible to treat with nonsurgical measures, but there are advantages to the other forms of treatment.
Physical therapy that caters to the injury can have noticeable impact within 12 to 16 weeks. Compared to surgery, it can be more effective with the right patient and outlook. For elder patients, it avoids the complications of surgery and the potential for multiple surgeries. For lighter tears, it means a faster repair time. The repair may be stronger than the arthroscopic method due to being natural growth. If there is any belief that therapy is a viable treatment choice, it is a serious option to consider.
As with any medical advice, be sure to consult your primary care physician and trusted medical professionals.
Andrew Huang is a sports injury clinical consultant. He enjoys sharing his insights and tips through blogging. Visit the link for more information on torn meniscus treatments.
Leave a Reply