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More Evidence that Knee Meniscus Surgery Causes Arthritis

POSTED ON IN Knee Latest News BY Chris Centeno

knee meniscus surgery

You gotta love medicine. In no other profession would something that has been shown to be ineffective continue to be done. As an example, we’ve known for years now that knee meniscus surgery doesn’t work. Despite that, it’s still the most common knee procedure in the United States. We also have some research to show that it likely causes or at least facilitates the development of knee arthritis. In fact, my practice is full of patients who are on their second meniscectomy and have been told they now need a knee replacement. This morning I’d like to review some research that places another nail in the proverbial coffin of knee meniscus surgery. First, let’s review knee meniscus surgery.

Knee Meniscus Surgery

The meniscus is a cushion of tissue that protects the cartilage in the knee joint. It rests between the upper and lower leg bones where they meet to form the knee joint. The meniscus can become torn due to wear and tear, most commonly, or trauma due to an injury. Surgeons love to operate on the meniscus and do so to the tune of about 700,000 surgeries a year.

We have some research already that shows that meniscectomy isn’t good for your knee cartilage. For example, check out this study that demonstrated that meniscus surgery likely increases the onset of arthritis. Why would this happen?

A meniscectomy, which accounts for over 95% of meniscus surgeries, involves excising, or removing, pieces of the meniscus. A surgeon will access the knee joint (via an open incision or an arthroscope) and cut out the torn piece of meniscus. Knowing the meniscus is there to protect the cartilage, it’s easy to understand why slicing out pieces of it could leave the cartilage vulnerable and potentially lead to arthritis.

It’s important to understand that just because your MRI shows a meniscus tear, this doesn’t mean you need surgery, especially in middle-aged or elderly patients. Watch my video below to get a more in-depth understanding of this:

Now, let’s look at the new study to learn more.

Knee Meniscus Surgery Now Means Knee Arthritis Later

The purpose of the new study was to investigate how meniscectomy affected the knee structure long term. The study consisted of 57 patients, each having received an arthroscopic partial meniscectomy (for traumatic or degenerative meniscus tears) within a period of 5 to 12 years (8 years average) prior. Using radiology images both before and in the years following meniscectomy, researchers studied the meniscectomy knee and compared it to the opposite knee that did not undergo surgery.

The results? Nearly 63% of knee meniscus surgery patients developed knee arthritis in the meniscectomy knee within 8 years, on average, following surgery. Compare this to the opposite knee that was not operated on: 28% developed arthritis in that same time period.

A few other interesting findings included knee arthritis in the medial compartment of the knee in males that was just under 9% prior to surgery and climbed to nearly 59% during the study period (females went from 26% to 73%). For obese patients, 18% had medial knee arthritis prior to meniscus surgery while a whopping 100% had it in the years following. Finally, in patients who had degenerative meniscus tears (tears due to wear and tear), 10% had medial knee arthritis prior to surgery while just under 67% had knee arthritis after. In patients with traumatic meniscus tears (injury related), 21% had medial knee arthritis prior to surgery while 63% had knee arthritis after.

More You Need to Know About Knee Meniscus Surgery

Despite the fact that orthopedic surgeons keep performing meniscus surgery and insurance keeps covering it, there are an abundance of problems plaguing the procedure, and it’s likely we’ll see this surgery relegated to the medical history books in the not-too-distant future. Let’s take a look at just a few of the issues I’ve covered over the last decade or so:

The upshot? Avoid meniscus surgery! If a surgeon tells you that you need this procedure because you’re middle-aged and you did something to cause your knee to hurt and an MRI randomly shows a meniscus tear (that was likely there before the accident), please run away. It’s time for surgeons to retire this procedure!

 

 

    comments

    Isabel says

    What pep therapy be useful for the treatment of meniscus tears?

    replies

    Regenexx Team says

    Isabel,

    Pep therapy is a respiratory therapy. In the event that it was a typo for PRP, here is how we treat meniscus tears nonsurgically with platelet procedures like prp, and bone marrow stem cells, both from the patient. Please see: https://www.regenexx.com/meniscus-tears/

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    Brian Sanderson says

    John T. Fairbank published his findings in 1948. So, for 70 years we should have known that hacking at the meniscus is a bad idea. Seventy years is a long time not to learn... Still, if the surgeon's won't learn, perhaps the patients might?

    replies

    Regenexx Team says

    Brian,
    That's the hope, which is why we write so much about it...

    replies

    john says

    Been reading your blog going on a couple years.
    I had this done due to chronic knee pain about 3 years back.
    As a non medical person, what you say sounds reasonable.
    Considering your procedures are not covered by insurance and they are rather costly (probably worth it but one is limited by ones wallet), what can be done given the pain involved to avoid this procedure (meniscectomy).

    replies

    Regenexx Team says

    john,
    The most important thing is accurate diagnosis. A traumatic sports injury or large tear may cause pain, but most meniscus tears do not cause pain, so determining what is actually causing the pain is crucial. The exam is generally covered if your insurance is in network, so finding out what's going on by examining you would be needed to advise. Generally speaking, avoiding steroid shots and NSAIDs, and taking Curcumin, good quality fish oil, and Chondroitin and Glucosamine can be helpful -or- the Regenexx Advanced Stem Cell Support Formula. Please see: https://www.regenexx.com/curcumin-for-knee-arthritis/ and https://www.regenexx.com/new-research-fish-oil-can-turn-bad-inflammation-into-healing/ and https://www.regenexx.com/controlling-middle-old-aged-inflammation-critically-important/ and https://www.regenexx.com/steroid-shots-for-knee-arthritis/ and https://www.regenexx.com/steroid-shots-for-knee-arthritis/ and https://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/

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    Mike says

    What can be done for those of us who had their menisci removed?
    Can this be regrown?

    How about implants?

    replies

    Regenexx Team says

    Mike,
    In the case of a complete meniscectomy, the meniscus can't be regrown. While there are many types of implants being tried, we've not seen one that has been successful. We can usually still help with both pain and function. If you would like to see if you would be a Candidate and see what would be involved in your case, please submit the "Are You a Candidate" form, or let us know. Please see: https://www.regenexx.com/hip-labrum-surgery-complications/

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    Perry L. says

    I’m now 76, physically healthy and active, former jogger, current aggressive bicyclist, mountain climber, and long distance backpacker. Over the years I have suffered traumatic tears of the medial menisci of both knees, once for the left knee, and twice for the right. The discomfort subsequent to these events prevented me from enjoying my customary activities. After several months of rest and attempts to rehab after each of these injuries I submitted to menisectomy surgeries. I’m happy to report that in my case the procedures worked. I continue to be pain free and able to engage in my usual active lifestyle. I believe that knee health depends upon staying active, as in “use it or lose it”.

    replies

    Regenexx Team says

    Perry,
    Your theory is correct! Physical activity is incredibly important. That said, if and when symptoms develop, be proactive and act quickly. Often just PRP can get things going back in the right direction.

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    Trish says

    I wish I read this article earlier. I had meniscus surgery on both knees in December 2018. I have never had pain relief. Prior to November 2018 I had no signs of arthritic pain. Yesterday, I was told I need a knee replacement in both knees. 50 years old, disappointed and mad at myself for not doing the proper research.

    replies

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    About the Author

    Chris Centeno

    Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…

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