Treatment of Meniscal Tear
Authors: Jeffrey N. Katz, Morgan H. Jones
Journal: Annals of Internal Medicine (2016)

Letters18 October 2016Treatment of Meniscal TearJeffrey N. Katz, MD, MSc and Morgan H. Jones, MD, MPHJeffrey N. Katz, MD, MScFrom Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and Cleveland Clinic, Cleveland, Ohio.Search for more papers by this author and Morgan H. Jones, MD, MPHFrom Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and Cleveland Clinic, Cleveland, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0326 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree, in general, with Drs. Buchbinder and Harris' critical assessment on the efficacy of APM in patients with degenerative meniscal tear. However, we would like to comment on 2 arguments that they make in support of their concluding statement that APM should not be offered to patients with degenerative meniscal tear.First, although APM is a risk factor for osteoarthritis progression, meniscal damage is a risk factor, as well (1). No studies to date have disentangled the effect of surgery from the effect of the underlying tear. At this point, advising a patient with meniscal tear that ...References1. Englund M, Roemer FW, Hayashi D, Crema MD, Guermazi A. Meniscus pathology, osteoarthritis and the treatment controversy. Nat Rev Rheumatol. 2012;8:412-9. [PMID: 22614907] doi:10.1038/nrrheum.2012.69 CrossrefMedlineGoogle Scholar2. Yim JH, Seon JK, Song EK, Choi JI, Kim MC, Lee KB, et al. A comparative study of meniscectomy and nonoperative treatment for degenerative horizontal tears of the medial meniscus. Am J Sports Med. 2013;41:1565-70. [PMID: 23703915] doi:10.1177/0363546513488518 CrossrefMedlineGoogle Scholar3. Sihvonen R, Englund M, Turkiewicz A, Järvinen TL; Finnish Degenerative Meniscal Lesion Study Group. Mechanical symptoms and arthroscopic partial meniscectomy in patients with degenerative meniscus tear: a secondary analysis of a randomized trial. Ann Intern Med. 2016;164:449-55. [PMID: 26856620]. doi:10.7326/M15-0899 LinkGoogle Scholar4. Gauffin H, Tagesson S, Meunier A, Magnusson H, Kvist J. Knee arthroscopic surgery is beneficial to middle-aged patients with meniscal symptoms: a prospective, randomised, single-blinded study. Osteoarthritis Cartilage. 2014;22:1808-16. [PMID: 25086401] doi:10.1016/j.joca.2014.07.017 CrossrefMedlineGoogle Scholar5. Katz JN, Brophy RH, Chaisson CE, de Chaves L, Cole BJ, Dahm DL, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013;368:1675-84. [PMID: 23506518] doi:10.1056/NEJMoa1301408 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and Cleveland Clinic, Cleveland, Ohio.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0049. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment of Meniscal Tear: The More We Learn, the Less We Know Jeffrey N. Katz and Morgan H. Jones Treatment of Meniscal Tear Rachelle Buchbinder and Ian Harris Metrics 18 October 2016Volume 165, Issue 8Page: 603KeywordsDisclosureKneesMedical risk factorsOsteoarthritisResearch reporting guidelinesSurgery ePublished: 18 October 2016 Issue Published: 18 October 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...