Meniscus surgery is wack

The meniscus acts as a cushion in the joint between the thigh and shin bone as well as providing extra stability at the knee.  It naturally moves forward and backward in the joint depending on the knee position.  

Arthroscopic surgery usually involves meniscectomy, which means to cut out or remove a portion of the meniscus.  Why would you want to cut out the cushion in your joint?  Could this possibly contribute to more "bone on bone"or joint irritation and degeneration?  The failure rate of meniscus surgery is fairly high (1), and often leads to total knee replacement. 

To top it off, research at the highest level is showing that there is no difference between groups for surgery verses no repair in 35-65 year olds (2).

Here are my suggestions:  

• Meniscus repair is recommended for younger patients <25-30 y/o especially if ACL is torn as well. This type of surgery is less common than arthroscopic meniscectomy surgery due to age of the patient and quality of the tissue, and involves "sewing" or repairing the meniscus without removing tissue.
  
• 30-60 y/o have conservative treatment first!  The right physical therapist will know how to mobilize the meniscus to prevent catching.  Often the meniscus will pinch between the thigh and shin bone either in the front or back of the knee causing discomfort and restricted range of motion.  This can quickly and easily be mobilized.
  
•  >60 y/o consider conservative treatment first, but may be a total knee replacement candidate.  At this age especially, it depends on your tissue quality, health, and activity levels.  With mild to moderate arthritis try physical therapy first.  With severe arthritis or degenerative joint disease total knee replacement may be best.  
  

1.)Majeed H, Karuppiah S, Sigamoney KV, Geutjens G, Straw RG. All-inside meniscal repair surgery: factors affecting the outcome. Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology. 2015;16(3):245-249. doi:10.1007/s10195-015-0342-2.
2.)  Sihvonen R, Paavola M, Malmivaara A The FIDELITY (Finnish Degenerative Meniscal Lesion Study) Investigators, et al
Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial
Annals of the Rheumatic Diseases 2018;77:188-195.