Common Knee Surgery May Boost Arthritis Risk, Study Suggests

 

The procedure repairs tears in the meniscus, a piece of cartilage that acts as a shock absorber. There are two in each knee, and they stabilize the knee joint. Meniscal tears are one of the most common knee injuries, and surgery is often performed to reduce pain and improve joint function, the researchers said.

In their study, the scientists used MRI scans to look at 355 knees with arthritis, and compared them to a similar number of knees without arthritis. The average age of the patients was about 60 and most were overweight.

All 31 knees that were operated on to repair meniscal tears developed arthritis within a year, compared with 59 percent of knees with meniscal damage that did not have surgery.

Cartilage loss occurred in nearly 81 percent of knees that had meniscal surgery, compared with almost 40 percent of knees with meniscal damage that did not have surgery, the study found.

The study was to be presented Wednesday at the Radiological Society of North America annual meeting in Chicago.

Even though surgery to repair meniscal tears is common, "increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint," study author Dr. Frank Roemer, from Boston University School of Medicine and the University of Erlangen-Nuremberg in Germany, said in a society news release.

"The indications for meniscal surgery might need to be discussed more carefully in order to avoid accelerated knee joint degeneration," he suggested.

An alternative to surgery is physical therapy to help maintain and restore knee muscle strength and range of motion. Ice and nonsteroidal anti-inflammatory medications (NSAIDs) are also used to treat pain and symptoms, according to the release.

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Weight Could Influence Rheumatoid Arthritis Relief

The study found that those who were heaviest had almost 65 percent reduced odds of disease remission. Being underweight also lowered the odds of remission.

"Medication for rheumatoid arthritis is not as effective on the overweight population," said Dr. Susan Goodman, the study's lead author and a rheumatologist at the Hospital for Special Surgery in New York City.

Findings from the new research were presented earlier this month at the American College of Rheumatology annual meeting in Boston. Studies presented at meetings are generally considered preliminary until they've been published in a peer-reviewed journal.

It's also important to note that while this study found a link between weight and rheumatoid arthritis remission, it wasn't designed to show whether or not weight was actually responsible for changes in remission status.

Almost 1.5 million Americans have rheumatoid arthritis, a chronic condition that causes painful joint swelling that can lead to joint deformity, according to the Arthritis Foundation. The disease is three times more common in women, and typically begins between ages 30 and 60, the Arthritis Foundation reported.

A major goal of treatment is to induce remission -- defined as no or low inflammation or no signs of active disease, according to the Arthritis Foundation.

Rheumatoid arthritis patients who achieve remission experience a significant reduction in symptoms, according to Goodman. Patients have achieved remission when they no longer have fatigue, swelling in their joints and short-lived morning joint stiffness, she noted. Patients are significantly more likely to attain these results if they adhere to a specific plan to combat the disease, Goodman said.

The current study followed nearly 1,000 patients -- who developed the disease at an early age -- for three years.

The researchers found that people who were underweight had 45 percent lower odds of achieving remission than people of normal weight. And, people who were obese (a body mass index -- or BMI -- of 35 to 40) or morbidly obese (a BMI over 40) had about 50 to 60 percent lower odds of achieving remission of their rheumatoid arthritis, according to the study. BMI is a measurement that roughly estimates how much body fat a person has.

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Antibiotics and Kids' Risk for Juvenile Arthritis

Antibiotics, which treat bacterial infections, may raise a child's risk of getting juvenile idiopathic arthritis, a disease that causes inflamed, swollen joints. That's according to investigators reporting at the American College of Rheumatology 2014 Annual Meeting in Boston.

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