Meniscus repair may yield better outcomes, be more cost effective vs. meniscectomy
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SAN FRANCISCO — The published literature has shown meniscus repair to be a successful technique, with slower osteoarthritis progression and better long-term outcomes compared with meniscectomy, according to a presenter here.
“If you look at studies that look at meniscus repair vs. meniscectomy head-to-head, we know if you repair, you have a less chance of osteoarthritis, better function and the outcomes are maintained over time where meniscectomy typically becomes worse at about 18 months,” David C. Flanigan, MD, said during a debate at the Arthroscopy Association of North America Annual Meeting.
However, Flanigan said the reoperation rates for both procedures are mixed, with higher ipsilateral knee surgery rates with meniscectomy and a slightly higher complication rate with meniscus repair.
When tear type is considered, the published literature has shown meniscectomy has worse outcomes and a high risk of radiographic symptomatic OA, regardless of the amount of resection, when used to treat complex meniscus tears, he said.
“If you look at any type of resection, you’re going to do worse and the tradeoff is potential higher risk of reoperation of the meniscus,” Flanigan said. “But time and time again, if you look at the cost effectiveness, meniscus repair wins out, whether it’s an isolated incident repair, meniscus repair with ACL reconstruction or root meniscus repair because they have improved long-term outcomes and, therefore, less chance of osteoarthritis changes, less chance of total knee arthroplasty and, therefore, cost savings.”
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Flanigan DC. Best to fix all and see who fails. Presented at: Arthroscopy Association of North America Annual Meeting. May 19-21, 2022; San Francisco.
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