Middle-aged and older patients are unlikely to benefit in the long term from surgery to repair tears in the meniscus, pads of cartilage in the knee, a new review of studies has found.
Researchers at McMaster University combined data from seven randomized, placebo-controlled trials involving more than 800 subjects treated for meniscal tears with surgery, sham surgery or nonoperative care. The subjects' average age was 56.
In six of the trials, the surgery provided a significant improvement in short-term functioning. But the pooled data showed no significant difference in long-term functioning among patients in the three groups. Nor did surgery provide either short- or long-term pain relief.
Dr. Moin Khan, a research fellow at the university and lead author of the study, published in the Canadian Medical Journal, said that its conclusion does not pertain to an acute meniscus tear in a young person. That requires surgery.
"But chronic pain from a small meniscus tear in a middle-aged person may not benefit from surgery," he said.
"Treatment with weight loss, anti-inflammatory medicine and physical therapy may be helpful for many patients."
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