In early osteoarthritic stage a meniscal tear should be treated either conservative or surgically depending on the type of tear and clinical signs. For example, repeated meiscal blockages are an absolute indication for partial or total meniscal removal usually through arthroscopy. In severe osteoarthritis, surgery should be considered, incl. tibia osteotomy or arthroplasty. In similar cases the meniscal tears are concomittant or secondary pathology.
Purely depends on the amount of demand from the individual.
Well !...if therez a meniscal tear in a O.A knee....check out how bad is the O.A . If its a Lawrence 3 or 4; u need a knee replacement ...if no than think of arthrocopy; wash out the knee, if its a repairable tear fix it...else debride and balance it !!!
OK i got you , so we are talking about menscal conservative management in case of Moderate to advanced OA and we will think only in HTO VS TKR ,, and in mild OA with symptomatic menscal pain do Ax management
We are treating degenerative meniscal lesions and OA grade 2-3 using autologous ex-vivo expanded mesenchymal stem cells administered intraarticularly. The results are quite good in special in relation to pain decrease. Results seems to improve if knee toilette is performed previously. Data for OA patients is not as good for patients grade 4, where the knee replacement is probably the unique option. And arthroscopy is the option when there is a knee blockage.
But as mentioned above, the diagnose should be accurate to indicate the best option for each patient.
There is also the possibility for treating these patients with bone marrow concentrate, or Platelet rich plasma. I have no expertise with these treatments, but as far as I know, cell treatments seems to have better results than PRP.
Yes, I totally agree with Panayot. Clinical signs are important in choosing the method of treatment and also the patient demands are very important.
i have a good experience using Hyalourinic acid injection inside the knee .. giving good result in moderate OA .. but the PRP i have no idea about using it
the choice of each line of treatment should be based on patient's age, sex, occupation as well as body weight.
for young athletes surgery may be the best while old aged with degenerated miniscui physiotherapy may be more suitable
treatment should be tailored for each patient.
Following any means to treat OA. Strengthening of the quadriceps muscles goes a long way.
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