Orthopaedic Surgeon - Canada

Recurrent locking is a concern. We need large studies on those that have a repair compared with those who have partial meniscectomy.

Orthopaedic Surgeon - United States

I did not see reference to the severity of arthritis in each study or whether patients with arthritis and meniscal tear were first treated for the arthritis before undergoing meniscectomy. If one treats an MRI finding of tear of meniscus with underlying arthritis arthroscipically without first treating the arthritis, results will be expected to be skewed if favor of non improvement with arthroscopic surgery. In my experience with performing over 5000 arthroscopic knee surgeries, patients with evidence of arthritis (Kellgren Lawrence grade 1-2) with concommitant meniscal tears should be treated for the underlying arthritis first. If they respond to NSAIDS, steroid injection, PT, etc ..then great. If locked knee or no benefit from steroid and other conservative measures, then consider arthroscopy (if positive McMurry's test and/or other positive findings on PE). This elimination of patients with arthritis considerably increases the likelihood that arthroscopy will be beneficial in the long term....jmho.