Knee Meniscectomy in the Geriatric Population: Not Recommended

Evidence Against Meniscectomy in Older Adults

The British Medical Journal clinical practice guideline makes a strong recommendation against arthroscopic knee surgery, including meniscectomy, for patients with degenerative knee disease, which is particularly common in the geriatric population 1
Arthroscopic surgery does not result in meaningful improvement in long-term pain or function for older patients with degenerative knee disease 3
The American Academy of Orthopaedic Surgeons (AAOS) recommends against performing arthroscopy with débridement or lavage in patients with a primary diagnosis of symptomatic osteoarthritis of the knee 4, 5
While some patients may experience small improvements in pain or function at three months post-surgery, these benefits are not sustained at one year 3
Surgical treatment subjects geriatric patients to increased risks including anesthetic complications, infection, and thrombophlebitis 4

Arthroscopic partial meniscectomy may be considered as an option only in specific cases where patients have primary signs and symptoms of a torn meniscus and/or a loose body 4, 6

Conservative management should be the first-line approach for geriatric patients with knee pain 1, 2
Options include watchful waiting 7, weight loss if overweight 7, physical therapy and exercise 7, oral or topical pain medications such as NSAIDs 7, and intra-articular corticosteroid injections 2, 7

Assess for degenerative knee disease (common in patients >50 years) and pursue conservative management options if present 1, 2, 7