Study suggests surgery better than observation for older patients with meniscus tear

Patients over age 50 who underwent an all inside arthroscopic repair technique had lower rates of subsequent total knee surgery than a similar group that was only observed, according to research presented at the American Orthopedic Society of Sports Medicine Annual Meeting today.

Dr. Jason L. Dragoo from Stanford Medicine in Redwood City, Calif., and his team of researchers followed 48 patients over age 50 who were diagnosed with a meniscal root tear. The meniscus is the spongy cartilage that provides cushion in the knee.

Dragoo and his team set out to compare the clinical outcomes of patients undergoing an all-inside arthroscopic repair technique versus non-operative management for posterior meniscal root tears.

Meniscal root tears affect both young healthy athletes and older patients with early degenerative knees. Root tears lead to de-tensioning of the meniscus and have been associated with increased contact forces and cartilage damage. Management of older patients with root tears is controversial and the efficacy of different treatment options is unclear.

During the follow-up period, only 3.3 percent of patients who received arthroscopic repair required a total knee surgery while 33.3 percent of patients in the observation group needed knee surgery.

"Our study found a significant improvement in all clinical outcome scores in the surgery group at two-year follow-up," said Dr. Dragoo. "Surgical management showed higher functional outcomes and decreased TKA conversion rates as compared to observation and should be considered as a treatment option for the treatment of meniscal root tears in the older population," he said.