This month in the American Journal of Sports Medicine, there was an excellent article out of Mayo Clinic that sought to evaluate the treatment of meniscus root tears. This has become an increasingly common injury that I see in my clinic and this is generally a very challenging problem. This is a unique type of meniscus tear that accounts for only about 4% or 5% of all the meniscus tears that we see, but has significant clinical ramifications for the patient.
This type of tear involves the attachment to the bone where there is complete destabilization of the meniscus and the meniscus gets pushed out of the joint. This is much more severe than a standard degenerative meniscus tear that may have a flap or piece that is torn, but the majority of the meniscus is intact. Instead, the meniscus root tear affects the attachment point of the meniscus and causes complete destabilization of the entire meniscus. As a result, the cartilage loses the support of the entire meniscus and can lead to rapid arthritis of the knee.
These generally happen in middle age and often are correlated with obesity and are more common in females. Unfortunately, there is often some rapid progression to degenerative arthritis and this is what we are trying to prevent with a repair. We have started to repair these much more commonly, as we have improved our surgical techniques and ability to do a repair.
In this study, there was a comparison of 45 patients who one-third underwent conservative treatment with no surgery, one-third had a surgery where a portion of the meniscus was removed, and one-third who had repair of the meniscus. There was a statistically significant improvement in patients who underwent repair versus the other 2 groups and prevention of development of arthritis in all 15 of those patients. The worst group underwent partial meniscectomy, where there was rapid progression to degenerative arthritis. This gives us good data that we should continue to repair these complex injuries in an attempt to preserve the knee joint and prevent progression to total knee or partial knee arthroplasty.
If you have been diagnosed with a meniscus tear or cartilage injury to the knee, please give us a call and we can evaluate for options to help you get back to doing the things that you love.
Andrew L. Merritt, MD is an orthopedic surgeon specializing in sports injuries of the knee. He treats athletes of all ages and provides medical coverage for many area teams and athletes. For more information about ACL reconstruction surgery, meniscus repair, meniscectomy, cartilage injuries, arthritis, or other knee injuries, please contact Proliance Orthopedic Associates at 425.656.5060 for a consultation with Dr. Merritt.