Surgery for Meniscus Cartilage Tears in the Knees Linked to Later Development of Osteoarthritis: Presented at RSNA

By Alex Morrisson

CHICAGO -- December 5, 2014 -- In a retrospective study, radiologically assessed osteoarthritis was observed only among patients who had previously undergone a surgical procedure to repair a meniscus cartilage tear, researchers said here at the 2014 Annual Meeting of Radiological Society of North America (RSNA).

Frank Roemer, MD, Boston University School of Medicine, Boston, Massachusetts, and colleagues assessed radiographic damage among 354 patients with meniscus tears who did not have surgery and 354 knees that had been surgically repaired.

They found 31 incident radiographically proven osteoarthritis -- all in the patients who had undergone surgery. They also found that in 58.9% of the 165 knees with prevalent meniscal damage there was also evidence of osteoarthritis at follow-up (odds ratio [OR] = 2.66; P

Of the 107 knees with meniscal damage, 39.5% showed cartilage loss and 80.8% of the 21 knees that underwent surgery showed cartilage loss. Risk of cartilage loss was significantly increased for knees exhibiting any prevalent meniscal damage without surgery (OR = 1.5; P

During the previous year, about 4% of the patients in the study underwent knee surgery. All of the 31 knees that showed evidence of osteoarthritis came from the group of patients what had undergone meniscus surgery (31 of 354 patients). Of the 354 patients who did not have surgery for their meniscus tears, none developed osteoarthritis.

“We found that in a group of patients without osteoarthritis, all knees that developed osteoarthritis within 1 year were among those patients who had meniscus surgery,” said Dr. Roemer. “We also observed that the risk for cartilage loss was much higher in patients who had knee surgery compared to those who had meniscus damage but did not have surgery.”

The retrospective study did not have access to pain symptoms that led to surgery, so Dr. Roemer said that those patients undergoing surgery for the meniscus tears might have benefited clinically.

“We only focused on knee structure in our study,” he said. “There are times when surgery is needed to improve patients’ symptoms, especially when the tear causes locking of the knee -- so-called bucket handle tears. These tears need to be treated urgently because they can serious effect patient mobility.”

[Presentation title: Meniscal Surgery Markedly Increases Risk for Incident Osteoarthritis and Cartilage Loss in the Following Year. Abstract VSMK51-03]

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