Structural change following treatment for meniscal tear and osteoarthritis – the jury is still out

Meniscal tears are commonly observed on MRIs obtained in middle-aged and older adults, with some studies suggesting a 35% prevalence in the 50-and-older population (1). Not all tears are symptomatic, but patients with these tears often seek treatment when they experience pain, swelling, or interference with valued activities. Physical therapy (PT) and arthroscopic partial meniscectomy (APM) are among the treatment options available to these patients, with clinical trials showing similar benefits in terms of pain and functional improvement for both (2).
Source: Osteoarthritis and Cartilage - Category: Rheumatology Authors: Tags: Editorial Source Type: research

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Conclusions: This systematic review and meta-analysis of high-quality literature provides relatively strong evidence that APM did not improve functional activity or reduce pain compared with the results with conservative treatment or sham operation in knees with mild or no osteoarthritis.
Source: Clinical Journal of Sport Medicine - Category: Sports Medicine Tags: Original Research Source Type: research
Imagine you’re walking along and suddenly experience excruciating knee pain. Though it initially seems stuck in one position, after a minute or two you can limp along home, but just barely. At your doctor’s visit, an x-ray is normal but symptoms continue for weeks. An MRI is performed and now you have an explanation: a torn meniscus. (Two menisci — rubbery cartilage pads that act as shock absorbers — separate the bottom of your knee bone from the top of your shin bone.) A month later, you’re no better despite rest, pain medicines, and physical therapy. It’s time for surgery to fix it, ri...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Injuries Osteoarthritis Pain Management Surgery Source Type: blogs
Polzer H Abstract OBJECTIVE: Arthroscopic tibiotalocalcaneal arthrodesis (TTCA) aims at reconstructing a pain-free, orthograde, and functional limb with reduced invasiveness and lower complication rates compared to open arthrodesis. INDICATIONS: Combined osteoarthritis of the ankle and subtalar joint or hindfoot malalignment. CONTRAINDICATIONS: Osteomyelitis/deep soft tissue infections, talus necrosis, severe deformity of hindfoot or distal tibia, pronounced boney defect, indication for combined total ankle replacement and subtalar fusion. SURGICAL TECHNIQUE: Patient in supine position; arthros...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
ConclusionPain improved considerably in both groups over 60 months. While ITT analysis revealed no statistically significant differences following TKR, greater frequency of TKR in those undergoing arthroscopic partial meniscectomy merits further study.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Original Article Source Type: research
Patients with meniscal tear experience similar levels of reduced pain and improved physical function when treated with either arthroscopic partial meniscectomy or physical therapy, according to a recent study. The study also found these improvements were long term—lasting through the five-year follow up...
Source: The Rheumatologist - Category: Rheumatology Authors: Tags: Conditions Osteoarthritis Arthritis & Rheumatology knee knee injury Knee Osteoarthritis (OA) meniscal tear surgery Source Type: research
ConclusionThe results of the present metanalysis support a paradigm shift in arthrogenous TMJ disorder treatment. There is a new evidence (though on a very low to moderate quality level) that minimally invasive procedures, particularly in combination with IAI of adjuvant pharmacological agents (PRP, HA or CS), are significantly more effective than conservative treatments for both pain reduction and improvement of MMO in both short (≤5 months) and intermediate term (6 months to 4 years) periods. In contrast to traditional concepts mandating exhaustion of conservative treatment options, minimally invasive procedures, ther...
Source: Journal of Cranio Maxillofacial Surgery - Category: ENT & OMF Source Type: research
ConclusionPain improved considerably in both arms over 60 months. While ITT analysis revealed no statistically significant differences in TKR use, greater TKR utilization in those receiving APM merits further study.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Full Length Source Type: research
CONCLUSIONS: The review found no placebo-or sham-controlled trials of surgery in participants with symptomatic mild to moderate knee osteoarthritis. There was low quality evidence that there may be no evidence of a difference between arthroscopic partial meniscectomy surgery and a home exercise program for the treatment of this condition. Similarly, low-quality evidence from a few small trials indicates there may not be any benefit of arthroscopic surgery over other non-surgical treatments including saline irrigation and hyaluronic acid injection, or one type of surgery over another. We are uncertain of the risk of adverse...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Publication date: Available online 29 March 2019Source: Diagnostic and Interventional ImagingAuthor(s): D. Filippiadis, G. Charalampopoulos, A. Mazioti, E. Alexopoulou, T. Vrachliotis, E. Brountzos, N. Kelekis, A. KelekisAbstractOsteoarthritis of the knee is the most common cause of chronic knee pain being more prevalent in middle-aged and elderly patients. Symptomatic patients complain of pain and mobility impairment. Therapeutic armamentarium includes physical therapy, oral pharmacologic therapy, intra-articular injections, nerve ablation or modulation, trans-catheter arterial embolization, minimally invasive arthroscopi...
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research
r H Abstract OBJECTIVE: Repair of the lateral ligament complex of the ankle joint; identification and treatment of intra-articular pathologies. INDICATIONS: Symptomatic chronic lateral ankle instability. Treatment of osteochondral lesions associated with lateral ankle instability. CONTRAINDICATIONS: Osteoarthritis of the ankle joint, risk factors such as peripheral occlusive disease, diabetic foot syndrome, complex regional pain syndrome. SURGICAL TECHNIQUE: Diagnostic arthroscopy of the ankle joint utilizing anterolateral and -medial portals; identification and treatment of intra-articular patholog...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research
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