Article Text

THU0549 Meniscal Injuries: Is there a Place for Conservative Management?
  1. E. Soliman1,
  2. A. Aldawoudy2
  1. 1Internal Medicine &Rheumatology, ALEXANDRIA FACULTY OF MEDICINE
  2. 2Orthopaedics, Alexandria Student Hospital, alexandria, Egypt


Background Meniscal injuries used to be managed operatively, whether scopically or even through open techniques. We observed that some patients with MRI diagnosed meniscal lesions, who have been surgically treated, did not have satisfactory outcomes regarding their pain and function. Whereas, others who were not surgically treated showed unexpected improved outcomes.

Objectives To evaluate the outcomes of conservative management of non-sport meniscal injuries through rehabilitation programs, and search for the factors that help in selecting patients who may avoid surgery

Methods 31 patients with MRI diagnosed meniscal injuries were included. Patients were chosen not to have mechanical symptoms or sport injuries, and optionally agreed on conservative management throughstandard rehabilitation. Patients were followed up for one year. Pain was assessed using the pain fraction of the knee injuries and osteoarthritis outcome score (KOOS). Pain scores were tested in relation to patient’s age, sex, history of trauma, laterality of symptoms and MRI grading of meniscal injury.

Results Comparison between KOOS at the beginning of the study and after one year revealed significant improvement in function and pain with16/31 patients having KOOS scores values above 80 (where 100 is the completely pain free score), and only 2 patients with scores less than 60. There was no relation between the pain scores and the different studied parameters.

Conclusions Taking a wait-and-see approach to manage non-sport meniscal injuries produces similar outcomes to surgical management. Conservative rehabilitation management still has a place in non-sport meniscal injuries. Parameters which can predict pain improvement and thus avoid unnecessary surgery need further studies to be clearly defined.

Disclosure of Interest None Declared

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