Can Even Experienced Orthopaedic Surgeons Predict Who Will Benefit From Surgery When Patients Present With Degenerative Meniscal Tears? A Survey Of 194 Orthopaedic Surgeons Who Made 3880 Predictions
- Arthroscopic partial meniscectomy (APM) is one of the most common orthopedic procedures.
BACKGROUND & OBJECTIVE
Arthroscopic partial meniscectomy (APM) is one of the most commonly made surgical decisions in orthopedic practice (1), and 75% of APMs are performed in patients older than 40 years of age (2). However, it has been consistently demonstrated that meniscal tears are common incidental findings in the general population, and that incidental meniscal tears are found on MRI in 60% of asymptomatic adults older than 50 years with radiographic evidence of osteoarthritis (3-5). Despite these findings, along with several interventional randomized controlled trials that have failed to demonstrate a clinically important benefit of APM over non-operative alternatives or sham surgery in middle-aged and older patients with symptomatic meniscal tears (6-9), there does not appear to be a decline in the number of APMs performed in daily practice.
The aim of this study was to examine the ability of surgeons to predict the outcome of treatment for arthroscopic partial meniscectomy (APM) and exercise therapy in middle-aged patients who present with meniscal tears.
The findings of this study suggest that orthopedic surgeons are unable to identify whether a patient with a non-obstructive meniscal tear will benefit from arthroscopic partial meniscectomy or exercise therapy.
Between December 2017 and March 2018, an online survey was conducted among orthopedic surgeons and orthopedic surgery residents. The survey was sent to 1111 orthopedic surgeons and residents active in the Netherlands (950 orthopedic surgeons and residents) and Australia (161