Should Torn Cartilage Be Removed?
Scientists have determined that easily obtainable clinical information can predict which patients with knee osteoarthritis (OA) are most likely to benefit from arthroscopy, according to research funded in part by the Arthritis Foundation.
Tears in the meniscus, a fibrocartilage shock absorber in the knee, often occur in people who also have knee OA. Physicians have limited information as to whether removing or repairing the torn part of the meniscus in a person with OA helps to decrease their knee pain. A research team from Yale University in New Haven, Conn., and Harvard Medical School in Boston have developed a statistical model that helps physicians better understand which patients with both meniscal tears and knee osteoarthritis are more likely to benefit from surgery and which patients should be treated conservatively.
The model relies on tear type, mechanical symptoms (intermittent locking, buckling, giving way), pain pattern, and bone marrow edema (lesions in the bone marrow visible by magnetic resonance imaging) to make these predictions. Fortunately, these four factors are readily available to physicians.
Lead scientist and Arthritis Foundation grant recipient, Lisa Gale Suter, MD, says about the predictive model, “It is not intended as a decision support tool, but rather to demonstrate how robust our clinical intuition is and to explore ways to improve care.”
Suter LG, et al. Arthroscopic partial meniscectomy in individuals with symptomatic osteoarthritis: who benefits? Abstract presented at American College of Rheumatology Annual Scientific Meeting. San Francisco, October 25-29, 2008.