I realize it has been a long time since I have written an Ask Dr. Geier column. Since I answer so many of these questions on my weekly show, I have neglected writing full columns on the blog. As I continue to get questions and comments from previous Ask Dr. Geier columns, I have decided to start writing them more frequently and regularly. So please keep sending your questions and comments, and I will do everything I can to respond either in these columns or on my show.
As always, please remember my disclaimer that I cannot and will not offer specific medical advice in this column or elsewhere on the blog, on my show, by email, or in social media. This is meant for general information and education. Please consult with your doctor for specific medical advice.
Will K. in Buffalo, New York asks:
I am 24-year-old male, not overweight at all, and I do not play sports. I had a partial meniscectomy done on my left knee due to a work-related injury. About half of my medial meniscus was removed. Am I guaranteed to get osteoarthritis and need a knee replacement when I’m older? Is there a chance that I wont need one at all? Is there anything I can do to prevent arthritis?
Great question! Unfortunately there isn’t a yes or no, black or white, answer.
The meniscus serves a role of shock absorber between the bones of the knee. Both menisci in every knee absorb much of the stress across the knees with every step. In theory, if a patient tears the meniscus and requires surgery that involves trimming out the torn part (a partial meniscectomy), then more of the stress transfers to the knee’s bone and cartilage.
With less protection against repetitive stress, it makes sense that degenerative changes could develop over time. True osteoarthritis and the need for later medical and surgical treatments can result. Yes, some patients with a history of partial meniscectomy could one day require knee replacement.
However, there is no guarantee that this degeneration will definitely occur. That is a key reason I rarely shut people down from sports or exercise. Many experts debate the idea of jogging after the surgeries due to fear of degenerative changes. Even if arthritis does occur, I think the value of exercise to overall health might outweigh that risk.
If people do wish to remain active, I think varying the types of sports and exercise can help slow potential wear and tear. People could add swimming, biking, upper body weight lifting, and other non-repetitive impact activities a few days each week.
A final point worth mentioning lies in the fact that the patient has little control over the outcome. Usually the pain of the meniscus tear causes enough difficulty that nonoperative treatment is unsuccessful. The surgeon decides to repair the meniscus or trim part of it out based on the location and orientation of the tear and not personal or patient preference. While active people often want to save the meniscus as a shock absorber, that possibility may have been hampered at the time of injury.