If your doctor recommends you get arthroscopic knee surgery for a meniscal tear, do some homework before moving forward with the operation. A new Johns Hopkins study published in JAMA reveals that even though arthroscopic partial meniscectomies (APMs) have no benefit whatsoever for people over 65, surgeons perform these procedures routinely. And, as with much surgery, there are risks of infection and complications.
Researchers studied Medicare data on 121,624 knee arthroscopies for meniscal tears that developed with age. It is one of the most common procedures for older adults, performed by 12,504 surgeons. Yet, many clinical trials have shown that the procedure unequivocally has no benefit in treating this degenerative disease in older adults.
In general, the clinical trials reveal that routine exercise and physical therapy provide additional benefits for meniscal tears in older adults. Surgery, by comparison, offers no benefit. However, for acute traumatic meniscal tears, often resulting from engaging in sports, the APM can be beneficial.
Notwithstanding the evidence against arthroscopic knee surgery for meniscal tears in older adults, thousands of surgeons continue to perform the procedure, jeopardizing people’s health and driving up health care spending unnecessarily. Perhaps, the surgeons have not seen the evidence or, perhaps, they choose to disregard it. Either way, the question is what is to be done about it.
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