title: New England journal of medicine article evaluating the usefulness of meniscectomy is flawed.
abstract: A controversial article was recently published in the New England Journal of Medicine titled "Arthroscopic Partial Meniscectomy Versus Sham Surgery for a Degenerative Meniscal Tear" by Sihvonen et al. We believe that readers of this article should be careful about making sweeping generalizations regarding the study findings given several methodologic flaws inherent in the population studied. There are significant concerns regarding the generalizability of these data. The actual study sample group is exceedingly small as compared with the normal volume of meniscal surgery the authors are reported to routinely perform. The authors' definition of a sham procedure must be revisited. The authors' final conclusion that "arthroscopic partial meniscectomy is of no value" is simply not what the study found. We share the concerns that several other leading authorities have recently expressed about the societal implications of this work. Arthroscopic partial meniscectomy has revolutionized the way we are able to treat symptomatic meniscal pathology. However, this procedure, like all surgical procedures, must be properly indicated to truly benefit our patients.
authors.affiliation: Kerlan-Jobe Orthopaedic Foundation and Sports Medicine Fellowship, Los Angeles, California, U.S.A.
authors.forename: Neal
authors.initials: N
authors.lastname: Elattrache
authors.affiliation: Department of Orthopaedic Surgery, University of Kentucky, Lexington, Kentucky, U.S.A.
authors.forename: Christian
authors.initials: C
authors.lastname: Lattermann
authors.affiliation: Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, U.S.A. Electronic address: michaelhannonmd@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Hannon
authors.affiliation: Department of Orthopaedics, Cartilage Restoration Center at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors.forename: Brian
authors.initials: B
authors.lastname: Cole
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008592:Menisci, Tibial / Q000601:surgery*; D009511:New England; D010919:Placebos; D012693:Serial Publications / Q000592:standards*; D000070600:Tibial Meniscus Injuries
chemical_list: D010919:Placebos