The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
the young person the runner who comes in they're 40 years old they're having knee pain it's new onset they don't have radiographic arthri the MRI shows a in iscal tear any of those versions you would fix I would try to yes this is assuming that their pain is from the meniscus
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if you're young and you have a meniscus tear and you heard that sham surgery is no better than that's not you you need to have your meniscus fixed if it can be fixed
so what are the things you need to rule out how do you rule out the patelofemoral syndrome how do you rule out the MCL sprain which might not show up or other injuries those things usually happen with an injury so you know you're not going to tell your MCL running unless you slipped and fall you're a lot of but a lot of my patients have patelofemoral pain which is basically overloading of the patelofemoral joint right so we talked about how if you squat at seven times body weight well running is a similar type of problem problem with the force at the kneecap and if you increased your duration of running your your mileage and the amount of times you've done it in a week you're going to overload the cartilage in the kneecap and you're going to generate pain so but that has a very particular feel to it an examination you can tell the difference between patellar pain in fact on examination patella femal pain I can't find anything I can't load it enough to generate the pain I can bend your knee every which way if you have a meniscus tear and I put some tor into it you're going to feel it so there just a different it's a different presentation with regards to injury also meniscus tears if there's no history of injury I want to know why why would this happen and so if something twists and then they have a miniscus tear the pain happened after an accident then I'm like okay I have to
so the young person the runner who comes in they're 40 years old they're having knee pain it's new onset they don't have radiographic arthritis the MRI shows a meniscal tear any of those versions you would fix I would try to yes this is assuming that their pain is from the meniscus and that's where this gets a little bit more like art than science
if you're young and you have a meniscus tear and you heard that sham surgery is no better than that's not you you need to have your meniscus fixed if it can be fixed