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Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review

OBJECTIVE: To summarize the literature investigating management, treatment strategies, short- and longer-term outcomes of treatment for meniscal tear in middle-aged and older adults. DESIGN: We performed a literature search using PubMed to identify relevant articles and selected 15 for a narrative s...

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Detalles Bibliográficos
Autores principales: McHugh, C.G., Opare-Addo, M.B., Collins, J.E., Jones, M.H., Selzer, F., Losina, E., Katz, J.N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384701/
https://www.ncbi.nlm.nih.gov/pubmed/35991623
http://dx.doi.org/10.1016/j.ocarto.2022.100282
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author McHugh, C.G.
Opare-Addo, M.B.
Collins, J.E.
Jones, M.H.
Selzer, F.
Losina, E.
Katz, J.N.
author_facet McHugh, C.G.
Opare-Addo, M.B.
Collins, J.E.
Jones, M.H.
Selzer, F.
Losina, E.
Katz, J.N.
author_sort McHugh, C.G.
collection PubMed
description OBJECTIVE: To summarize the literature investigating management, treatment strategies, short- and longer-term outcomes of treatment for meniscal tear in middle-aged and older adults. DESIGN: We performed a literature search using PubMed to identify relevant articles and selected 15 for a narrative summary on the available evidence. RESULTS: The literature suggests that middle-age and older adults with meniscal tear may benefit from initial physical therapy (PT) potentially followed by arthroscopic partial meniscectomy (APM) for those who do not experience sufficient benefit after PT and in whom other sources of pain are deemed unlikely. There is moderate evidence to suggest that some factors at baseline, such as radiographic OA, meniscal tear type, and pain at baseline may influence outcomes after APM. Over time, APM appears to increase the risk of degenerative changes in cartilage, bone, and other knee structures as evidenced by radiograph and MRI-based assessments. CONCLUSION: Evidence from research investigating outcomes of treatment for meniscal tear in middle-aged and older adults demonstrates that PT is a reasonable initial treatment. More research is needed to investigate the best treatment for those who do not benefit substantially from initial PT. The evidence also demonstrates that APM may be associated with greater risk of radiographic osteoarthritic changes, though more research and the addition of enhanced quantitative MRI-assessments are needed to further detail any compositional changes in the knee. Focusing on these areas of further study will clarify whether these imaging findings are clinically meaningful.
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spelling pubmed-93847012022-09-01 Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review McHugh, C.G. Opare-Addo, M.B. Collins, J.E. Jones, M.H. Selzer, F. Losina, E. Katz, J.N. Osteoarthr Cartil Open REVIEW(S) OBJECTIVE: To summarize the literature investigating management, treatment strategies, short- and longer-term outcomes of treatment for meniscal tear in middle-aged and older adults. DESIGN: We performed a literature search using PubMed to identify relevant articles and selected 15 for a narrative summary on the available evidence. RESULTS: The literature suggests that middle-age and older adults with meniscal tear may benefit from initial physical therapy (PT) potentially followed by arthroscopic partial meniscectomy (APM) for those who do not experience sufficient benefit after PT and in whom other sources of pain are deemed unlikely. There is moderate evidence to suggest that some factors at baseline, such as radiographic OA, meniscal tear type, and pain at baseline may influence outcomes after APM. Over time, APM appears to increase the risk of degenerative changes in cartilage, bone, and other knee structures as evidenced by radiograph and MRI-based assessments. CONCLUSION: Evidence from research investigating outcomes of treatment for meniscal tear in middle-aged and older adults demonstrates that PT is a reasonable initial treatment. More research is needed to investigate the best treatment for those who do not benefit substantially from initial PT. The evidence also demonstrates that APM may be associated with greater risk of radiographic osteoarthritic changes, though more research and the addition of enhanced quantitative MRI-assessments are needed to further detail any compositional changes in the knee. Focusing on these areas of further study will clarify whether these imaging findings are clinically meaningful. Elsevier 2022-06-07 /pmc/articles/PMC9384701/ /pubmed/35991623 http://dx.doi.org/10.1016/j.ocarto.2022.100282 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle REVIEW(S)
McHugh, C.G.
Opare-Addo, M.B.
Collins, J.E.
Jones, M.H.
Selzer, F.
Losina, E.
Katz, J.N.
Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review
title Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review
title_full Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review
title_fullStr Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review
title_full_unstemmed Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review
title_short Treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: A narrative review
title_sort treatment of the syndrome of knee pain and meniscal tear in middle-aged and older persons: a narrative review
topic REVIEW(S)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384701/
https://www.ncbi.nlm.nih.gov/pubmed/35991623
http://dx.doi.org/10.1016/j.ocarto.2022.100282
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