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. 2022 Sep;4(3):100282.
doi: 10.1016/j.ocarto.2022.100282. Epub 2022 Jun 7.

Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review

C G McHugh  1 , M B Opare-Addo  1 , J E Collins  1   2 , M H Jones  1   2 , F Selzer  1   2 , E Losina  1   2   3 , J N Katz  1   4   2   5
Affiliations

Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review

C G McHugh et al. Osteoarthr Cartil Open. 2022 Sep.

Abstract

Objective: To summarize the literature investigating management, treatment strategies, short- and longer-term outcomes of treatment for meniscal tear in middle-aged and older adults.

Design: We performed a literature search using PubMed to identify relevant articles and selected 15 for a narrative summary on the available evidence.

Results: The literature suggests that middle-age and older adults with meniscal tear may benefit from initial physical therapy (PT) potentially followed by arthroscopic partial meniscectomy (APM) for those who do not experience sufficient benefit after PT and in whom other sources of pain are deemed unlikely. There is moderate evidence to suggest that some factors at baseline, such as radiographic OA, meniscal tear type, and pain at baseline may influence outcomes after APM. Over time, APM appears to increase the risk of degenerative changes in cartilage, bone, and other knee structures as evidenced by radiograph and MRI-based assessments.

Conclusion: Evidence from research investigating outcomes of treatment for meniscal tear in middle-aged and older adults demonstrates that PT is a reasonable initial treatment. More research is needed to investigate the best treatment for those who do not benefit substantially from initial PT. The evidence also demonstrates that APM may be associated with greater risk of radiographic osteoarthritic changes, though more research and the addition of enhanced quantitative MRI-assessments are needed to further detail any compositional changes in the knee. Focusing on these areas of further study will clarify whether these imaging findings are clinically meaningful.

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Conflict of interest statement

At the end of the text, under a subheading “Conflict of interest statement” all authors must disclose any financial and personal relationships with other people or organisations that could inappropriately influence (bias) their work. Examples of potential conflicts of interest include employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and research grants or other funding.

References

    1. Englund M., Guermazi A., Gale D., Hunter D.J., Aliabadi P., Clancy M., et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N. Engl. J. Med. 2008;359:1108–1115. - PMC - PubMed
    1. Farina E.M., Lowenstein N.A., Chang Y., Arant K.R., Katz J.N., Matzkin E.G. Meniscal and mechanical symptoms are associated with cartilage damage, not meniscal pathology. J. Bone Joint. Surg. Am. 2021;103:381–388. - PubMed
    1. McBride G.G., Constine R.M., Hofmann A.A., Carson R.W. Arthroscopic partial medial meniscectomy in the older patient. J. Bone Joint. Surg. Am. 1984;66:547–551. - PubMed
    1. Schimmer R.C., Brulhart K.B., Duff C., Glinz W. Arthroscopic partial meniscectomy: a 12-year follow-up and two-step evaluation of the long-term course. Arthroscopy. 1998;14:136–142. - PubMed
    1. Kuraishi J., Akizuki S., Takizawa T., Yamazaki I., Matsunaga D. Arthroscopic lateral meniscectomy in knees with lateral compartment osteoarthritis: a case series study. Arthroscopy. 2006;22:878–883. - PubMed