Common knee surgery may contribute to arthritis

Surgery often used to repair meniscal tears may increase the risk of osteoarthritis and cartilage loss in some people, according to research presented at the annual meeting of the Radiological Society of North America.
The meniscus is a wedge-shaped piece of cartilage in the knee that acts as a shock absorber between the thighbone and the shinbone. Meniscal tears are one of the more common knee injuries, and surgery is often performed to alleviate pain.
A group of volunteers (average 60.2 years old, two-thirds women) who were mostly overweight were involved in the study. A total of 355 knees had developed osteoarthritis during a five-year period. They were compared with a control group matched for age, gender, arthritic severity in both knees and body mass index.
Of all knees, 31 had meniscal surgery during the year before to the arthritis diagnosis, and 280 knees had signs of meniscal damage on MRI but did not have surgery. Some control cases had no meniscal damage.
The researchers assessed the risk of developing arthritis and cartilage loss during the following year for the different groups.
All 31 of the knees that had meniscal surgery in the prior year developed osteoarthritis, compared with 59% of the knees with meniscal damage that didn’t have surgery. Cartilage loss was more common in knees that had surgery: 80.8% of knees with surgery showed cartilage loss, compared with 39.5% of knees with meniscal damage and no surgery.
“We found that patients without knee osteoarthritis who underwent meniscal surgery had a highly increased risk for developing osteoarthritis and cartilage loss in the following year compared to those that did not have surgery, regardless of presence or absence of a meniscal tear in the year before,” explains Dr Frank Roemer, who led the study. “Meniscal surgery is one of the most common orthopedic procedures performed to alleviate pain and improve joint function. However, increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint.”
An alternative to surgery is conservative management, which includes ice, anti-inflammatory medication and physiotherapy to help maintain and restore muscle strength and motion.

Image credit: Sophie & Cie

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