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Webinar with Dr. Cobb

Episode 185: Arthroscopic Meniscal Repairs

Video Highlights

- Study shows no difference between surgery and exercise.
- Roughly 75% of meniscus surgeries can be avoided.
- Talk to your physician about exercise therapy and avoiding the risk of surgery.

Today we’re doing a little Public Service Announcement about arthroscopic meniscal repairs.

Today I want to talk about a study that’s just come out. It actually is a repeat of stuff that we’ve been talking about for the last 15 years, but it’s specifically talking about meniscus injury, or meniscus degeneration in middle aged and older people.

If that doesn’t fit you, you can still listen, because it’s still a good bit of information to know. If you’re not familiar with the idea of a meniscus, a meniscus is a little cartilaginous ring that sits in the knee. It is very common for people to complain of clicking and popping and pain in their knee. As a result of that, they go through traditional evaluations, and often times people are told that they need meniscus repair surgery that is done arthroscopically.

There are times, please hear me clearly, the surgery needs to be done. I’m not saying that. I’m saying all these decisions must be made with your healthcare provider. Now that I’ve said that, I want to talk a little bit, though, about the research that’s coming out. This is very, very important and very powerful because what has been believed for a long time is that some tears in the meniscus, you need to go in there and clean them up or remove little pieces, et cetera.

What happened recently, is a study was published out of Scandinavia. Basically they looked at a two year process. They took roughly 150 people, I think it was 142, and they all were diagnosed with degenerative meniscal tears. As a result of that, they said we’re going to split them into two groups. Half of them we’re going to do surgery on, and half of them are going to only do exercise therapy. Then they followed them for two years.

What they found was that the results were completely equal. There was no difference in the surgery group versus the exercise group in terms of pain, functional improvement … But most importantly, what they pointed out was that the exercise group actually was stronger than the group that just had the surgery.

Now the reason that I’m bringing this up is that the end of that study, they say that they believe that roughly 75% of meniscus surgeries can be avoided. If you know someone that’s complaining of this condition, they’ve been diagnosed with it, their recommendation is that you see or work with a therapist or trainer. They give very specific recommendations.

This is what they did in the study. The group trained two to three times a week for 12 weeks. That’s 24 to 36 training sessions. In those sessions, they did pretty basic stuff. They worked on strengthening the quadriceps, strengthening the hamstrings, strengthening the external and internal rotators, the abductors and adductors of the leg, and also strengthening the calf and the front of the leg as well. So basically you work on strengthening all the muscles around the knee that support it, and again, it’s super important that you hear, that strengthening had equal effects to surgery and the side benefit of making them stronger and more functional.

If you’re in this position, you go, “Okay, I’ve had some knee issues,” and you’ve been told you had degenerative meniscal tears, make it important to yourself to get out and talk to a therapist and trainer who understands the knee, and they understand how to go through this rehabilitation process.

Like I said, the authors of that study are echoing what’s been said in the United States for the last 15 years by the Orthopedic Society, that says most meniscal repairs, particularly in this category that are either from degeneration or wear and tear, are not necessary, and in fact, people will do much better doing exercise therapy and avoiding the risk of surgery.

With that said, the last thing I want to point out is right now in the United States, 700,000 of these procedures are done per year. They’ve been trying to change this for the last 15 years. If you talk to someone, and they go, “I think you need this,” make sure that you consider a second opinion, and ultimately you can always follow the advice of the authors of this most recent study who said, “Give exercise a shot.” The surgeon will still be there, so if you have this condition, you’ve been diagnosed with it, try exercise therapy first. If that doesn’t work, you can always have the surgery later. But it is smarter and safer to avoid the potential complications of surgery and focus on getting strong first. All right?

I’d like to say this was just a little Public Service Announcement, because sometimes I run across these studies that echo things that we’ve been talking about for many years, and I think they’re very important for people to hear.

If you have any questions about this, let us know. We’ll put a link to an article about this so you can read about it yourself. Otherwise, good luck, and I’ll speak to you soon.

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