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CHICAGO -- Individuals with knee pain who undergo surgery to repair meniscus cartilage tears often develop osteoarthritis in that knee within a year of the operation, researchers reported here.
Incident radiographic-diagnosed osteoarthritis was observed in 31 knees that had meniscal surgery and 58.9% of the 165 knees with prevalent meniscal damage (odds ratio 2.66,95% CI 1.81-3.89, P<0.05), said researcher associate professor of radiology at Boston University School of Medicine.
Action Points
- Note that these studies were published as abstracts and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
At a press conference at the 100th annual meeting of the Radiological Society of North America, Roemer also reported that 39.5% of 107 knees with meniscal damage and 80.8% of 21 knees that underwent surgery showed cartilage loss. Risk of cartilage loss was significantly increased for knees exhibiting any prevalent meniscal damage without surgery (OR 1.5 95% CI 1.1-2.2, P<0.05), and markedly further increased for knees that had surgery (OR 13.1 95% CI 4.7-36.3, P<0.05), he said.
During the previous year, about 4% of the patients in the study underwent knee surgery. All of the 31 knees that showed evidence of osteoarthritis came from the group of patients that had undergone meniscus surgery -- 31 of 354 patients. Of the 354 patients who did not have surgery for their meniscus tears, none developed osteoarthritis.
"We found that in a group of patients without osteoarthritis, all knees that developed osteoarthritis within 1 year were among those patients who had meniscus surgery," he said. "We also observed that the risk for cartilage loss was much higher in patients who had knee surgery compared with those who had meniscus damage but did not have surgery."
The retrospective study did not have access to pain symptoms that led to surgery, Roemer said, so those patients undergoing surgery for the meniscus tears might have benefited clinically. "We only focused on knee structure in our study," he said. He told 51˶ that the type of surgery was not apparent from the records accessed for the study but he believed that most of the procedures were performed through arthroscopic rather than open surgery.
"There are times when surgery is needed to improve patients' symptoms," he said, "especially when the tear causes locking of the knee -- so-called bucket handle tears. These tears need to be treated urgently because they can seriously effect patient mobility."
How surgery could cause osteoarthritis is "not clearly understood," he said.
Press conference moderator , assistant professor of radiology at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, said, "I think these are really important findings, especially considering the value of meniscal surgery. The findings shed important light on the risks associated with this treatment as we try to determine the benefits of this surgery, and the [study] results will add to that discussion."
Roemer said the patients were characteristic of individuals with meniscus tears. They were about 60 years of age, were predominantly women, and they tended to be overweight.
"Each person should discuss the pros and cons of having meniscal surgery with his or her doctor in order to avoid accelerating the onset of osteoarthritis," he said.
Disclosures
Roemer disclosed relevant relationships with Boston Imaging Core Lab.
Faintuch disclosed no relevant relationships with industry.
Primary Source
Radiological Society of North America
Source Reference: Roemer F, et al "Meniscal surgery markedly increases risk for incident osteoarthritis and cartilage loss in the following year" RSNA 2014; Abstract VSMK51-03.