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In December '02, I had arthroscopic knee surgery partial meniscetomy and media chrondroplasty. THe pain subsided for about 6 months, then returned in earnest whenever I skied or hiked. With increasing pain, I recently had an MRI, and seen a surgeon. He essentially indicated he would remove the meniscus altogether, but the pain relief would only last 6 months - 2 years. Ultimately, I would need a knee replacement. A lot of physical therapists and other health care professional friends and acquantancies have recommended I go through the surgery, and all will be fine. However, the time limitation bothers me. If I will ultimately need a knee replacement, why wait? I'd prefer to have the surgery at my present age (52) rather than waiting until I'm older and the recovery time is increased. What I'd like to know is will the effectiveness of the surgery be as brief as the surgeon indicated?

Customer (name blocked for privacy)

Hi,
While it is difficult to make a prediction about the effectiveness of the actual surgery since this is based on many factors here are a few things that you should keep in mind,
"Partial or total meniscectomies, whether open or arthroscopic, appear to be effective in removing torn pieces of the meniscus to prevent them from causing pain and interfering with knee action. Partial meniscectomy will maintain more of the knee's stability and allow a faster and more complete recovery. One review reports that 24% of those who had total meniscectomies, as compared with 14% of people who had partial meniscectomies, still had symptoms 6 or more years after surgery.2

As compared with a total meniscectomy, partial meniscectomy requires shorter operating times and results in a faster recovery, better postoperative functioning, and a better self-assessment of outcome.2
Risks

Meniscectomy is generally well tolerated and does not usually cause complications. However, there is a risk of damaging the nerves during surgery.

There is a direct relationship between the amount of meniscus tissue that is surgically removed and the load distribution across the knee. If more tissue is removed, the knee is less able to sustain the load of walking, running, or other activities. With uneven load distribution, degeneration of the knee joint may happen at a faster pace than it would with an intact meniscus.5

In any surgery, there is risk of infection or bleeding, and there are risks with general or regional anesthesia.
What To Think About

Surgical repair is generally favored over a partial or total meniscectomy. If the meniscus can be repaired successfully, it reduces the risk of knee joint degeneration that may occur with removal of all or part of the meniscus.

A recent study reports that the development of arthritis in the knee after meniscectomy may be influenced by heredity and environmental factors. This finding is significant because surgical removal of meniscal tissue has been considered the cause of osteoarthritis in the knee. If this study's findings are correct, surgery may be a factor, but not the only factor, in eventual osteoarthritis in knees"
Source:
http://www.healthwise.net/hillhealth/Content/StdDocument.aspx?DOCHWID=uh2055&SECHWID=uh2056

Also there is a new procedure called meniscus transplant surgery that might be useful and you ought to discuss this with your surgeon,

Do let me know if you need more information, remember to 'accept' the reply if you find it useful & give a positive rating,
Regards
Dr. Gupta

Reply to Gaurav Gupta's Post: Hi Doc,

I appreciate your very informational reply. Your response and article would indicate I would have to limit my skiing and hiking. I'm a very active person, and this doesn't sound very hopeful.

Thank you.

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