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<p>In summary, conservative treatment of degenerative meniscal lesion (DML) appears to have advantages compared to arthroscopic partial meniscectomy (APM) as an initial measure. The reasons for an APM are persistent pain for more than 3&#xa0;months with or without mechanical clinical symptoms in connection with a&#xa0;DML and abnormal conspicuous magnetic resonance imaging (MRI) after conservative treatment. If there are clear mechanical symptoms with daily pinching and subsequent blockage, an APM can be considered earlier. Conventional radiological signs of gonarthrosis (GA) alone in DML do not constitute an indication for surgical treatment. The prognosis after APM is positively influenced by several factors, such as lack of cartilage damage, low body weight, intact meniscal base after APM, orthograde axial relationships and stable ligament conditions. These should therefore be discussed together with the advantages and disadvantages in the treatment decision. An APM with removal of the unstable part of the meniscus can be advantageous for creating a&#xa0;stable tear or a&#xa0;smoothed residual meniscus. The aim should always be to preserve the healthy meniscus as much as possible as any reduction in the meniscus area is associated with a&#xa0;change in load and biomechanics. An excessive meniscectomy can lead to increased wear of the cartilage, resulting in degeneration of the joint and subsequent osteoarthritis. After APM, weakened musculature is a&#xa0;frequently observed concomitant pathology. A&#xa0;postoperative rehabilitation program leads to an improvement in pain, knee function and strength over a&#xa0;period of 1 year compared to patients without postoperative physiotherapy.</p>

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Ist die operative Behandlung des degenerativen Meniskusschadens noch zeitgemäß?

  • 期刊论文

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  • 发表日期：

    2025年3月28日

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  • Annika Siebe,
  • Matthias Krause

摘要

In summary, conservative treatment of degenerative meniscal lesion (DML) appears to have advantages compared to arthroscopic partial meniscectomy (APM) as an initial measure. The reasons for an APM are persistent pain for more than 3 months with or without mechanical clinical symptoms in connection with a DML and abnormal conspicuous magnetic resonance imaging (MRI) after conservative treatment. If there are clear mechanical symptoms with daily pinching and subsequent blockage, an APM can be considered earlier. Conventional radiological signs of gonarthrosis (GA) alone in DML do not constitute an indication for surgical treatment. The prognosis after APM is positively influenced by several factors, such as lack of cartilage damage, low body weight, intact meniscal base after APM, orthograde axial relationships and stable ligament conditions. These should therefore be discussed together with the advantages and disadvantages in the treatment decision. An APM with removal of the unstable part of the meniscus can be advantageous for creating a stable tear or a smoothed residual meniscus. The aim should always be to preserve the healthy meniscus as much as possible as any reduction in the meniscus area is associated with a change in load and biomechanics. An excessive meniscectomy can lead to increased wear of the cartilage, resulting in degeneration of the joint and subsequent osteoarthritis. After APM, weakened musculature is a frequently observed concomitant pathology. A postoperative rehabilitation program leads to an improvement in pain, knee function and strength over a period of 1 year compared to patients without postoperative physiotherapy.