Published last month in The Journal of Orthopaedics, the study compared immediate post-operative pain and patient-reported outcomes after partial meniscectomy with a needle versus standard arthroscopy. Unlike standard arthroscopy, needle arthroscopy is a minimally invasive procedure that uses a 1.9 mm nanoscope that enables the surgeon to view and access tighter spaces to repair the damaged joint with only a single or no incision. Used to alleviate knee pain in older patients, a partial meniscectomy consists of removing as little of the damaged part of the meniscus as possible to smooth the tear’s edges and avoid fraying.
The researchers performed a retrospective review of a consecutive series of patients who underwent partial meniscectomy before and after adoption of a needle arthroscopic technique. Meniscus repairs, root repairs and those with ligamentous injuries were excluded. Morphine consumption, the Visual Analog Scale (VAS) for pain and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were compared before surgery and at two and six weeks after surgery. While patients reported substantially less pain and improved patient outcomes at two weeks, differences were not sustained at six weeks after surgery.
“This nanoscope advance has great potential impact in regard to earlier return to sports and decreased use of opioids and other pain management drugs,” said Timothy E. Hewett, Ph.D., professor at the Marshall University Joan C. Edwards School of Medicine.
Marshall University’s orthopaedic surgery team has explored the use of needle arthroscopy since 2020. A clinical trial is currently underway at Marshall comparing the needle and standard arthroscopies for treatment of meniscus tears.
“Marshall was one of the first in the country to use the nanoscope, and we have worked to enhance patient care with the device,” said Chad D. Lavender, M.D., orthopaedic surgeon at Marshall Health and assistant professor at the Joan C. Edwards School of Medicine. “In this pilot study, we saw our initial hypothesis of less pain and improved scores by using a smaller scope held true, and we are excited about our current randomized trial that is looking at similar findings.”
To view the article in its entirety, visit: https://www.sciencedirect.com/science/article/abs/pii/S0972978X23001307