Management for degenerative meniscal tears

Management for people aged 45 years and older with a suspected degenerative meniscal tear is the same as for those with degenerative osteoarthritis (OA). See Essential features of osteoarthritis management for essential features of OA management, and for analgesic recommendations for OA, see:
Note: Current evidence does not support a role for arthroscopic partial meniscectomy, knee ‘washouts’ or arthroscopic debridement, in the management of degenerative meniscal tears.

Current evidence does not support a role for arthroscopic partial meniscectomy, knee ‘washouts’, and arthroscopic debridement in the management of degenerative meniscal tears.

Many trials have not been able to show any clear benefit of surgery over placebo or nonsurgical treatment for degenerative meniscal tears. A 2019 Cochrane review1 identified a single study that compared arthroscopic partial meniscectomy to a 6-week individualised home physical therapy programPalmer, 2019. There was little difference in pain and function (at 12-months follow up) between people who had arthroscopic partial meniscectomy and those who had physical therapy.

A 2020 systematic review and meta-analysis2 evaluated the efficacy of arthroscopic partial meniscectomy for symptomatic degenerative meniscal tears associated with mild or no OALee, 2020. Five randomised controlled trials were included in the final analysis. There was relatively strong evidence that arthroscopic partial meniscectomy did not improve functional activity or reduce pain, compared with those who had nonsurgical treatment or sham operation.

1 Palmer JS, Monk AP, Hopewell S, Bayliss LE, Jackson W, Beard DJ, et al. Surgical interventions for symptomatic mild to moderate knee osteoarthritis. Cochrane Database Syst Rev 2019;7(7):CD012128. [URL]Return
2 Lee SH, Lee OS, Kim ST, Lee YS. Revisiting Arthroscopic Partial Meniscectomy for Degenerative Tears in Knees With Mild or No Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin J Sport Med 2020;30(3):195-202. [URL]Return