• Patient Satisfaction
  • Surgeons on Satisfaction

    Overestimating Patient Satisfaction after Meniscectomy

       Patients usually satisfied?

    Q: What percent of meniscectomy patients do you think end up “Highly Satisfied” versus “Partly Satisfied” versus “Dissatisfied” with their surgery for torn meniscus?  What do you think are the key differences among these meniscus surgery patients?

    “If we stretch the indication for the surgery… arthroscopy doesn’t help arthritis”

    “The key difference between ‘highly satisfied’ patients versus ‘partly satisfied’ patients is that the partly satisfied patients are still likely to have ongoing pain issues. I think what happens is that, we kind of stretch the indication for the meniscus surgery and we think that the patient will get better with surgery when they really won’t because they have arthritis, and the arthroscopy doesn’t help arthritis. MRI makes it easier to identify a torn meniscus and it’s easy treat too, and surgeons feel comfortable with it. read moreYou see you can’t always accurately observe the arthritis in the x-ray, and the MRI can sometimes be misleading. Sometimes there’s a surprise when you go into surgery; and you think you’ve got only a meniscus tear, and you end up having an arthritis problem too.” Orthopaedic Surgeon

     

    Key Points

    Surgeons often overestimate how satisfied meniscectomy patients are.  Meniscus surgery can yield good patient satisfaction, but not for everyone.

    • Formal medical papers typically have said that partial meniscectomy is safe and effective. For example, one study3 said 88% of patients had good outcomes after 15 years. A second study4 said 90% had good outcomes after two years but that went down to 62% after 8 years.
    • In Real Surgery research, patient satisfaction was measured. This is related to a patient’s speed of recovery, return to normal activities, freedom from continuing pain, and properly set expectations. Comparing patient and surgeon responses in this research, surgeons are likely to substantially overestimate patient satisfaction with meniscus surgery.
    • Also, many surgeons noted a tendency by some of their colleagues to “overstretch the indication” for meniscus surgery. This means surgeons recommend surgery even when the benefit may be uncertain, such as if arthritis is the cause of pain more so than the meniscus tear.
      (see highly satisfied meniscectomy patientspartly satisfied meniscectomy patients,
      dissatisfied meniscectomy patients)

    Surgeon Estimate of Satisfaction with  Meniscus Surgery

    More Patient Quotes

    “Didn’t have expectations set properly…couldn’t see extent of arthritis”

    “I think that a portion of the unsatisfied patients just did not have their expectations set properly. And a portion of it is it that we truly couldn’t see the extent of the arthritis and we are surprised at the time of surgery. Between the two of those, you can explain the bulk of the unsatisfied patients.” Orthopaedic Surgeon

    “Over 60 years, unsatisfied could run as high as 60 or 70%”

    “If you’re talking young people under 30, then your highly satisfied group probably is going to be close to 80%; and if you’re talking about people over 60 who start to have some degenerative changes, then your highly unsatisfied could run as high as 60 or 70%.” Orthopaedic Surgeon

    “May have an underlying arthritic change”

    “Patients who end up dissatisfied often have had a complication, or their pain just doesn’t go away. They may have an underlying arthritic change. Sometimes even without arthritis, the meniscus just continues to hurt, and the pain just doesn’t go totally away, but that’s pretty rare.” Orthopaedic Surgeon

    “Patients sometimes have an unrealistic expectation of surgery”

    “Sometimes there is a difference between what the doctor thinks is going to happen and what the patient thinks is going to happen. I think patients sometimes have an unrealistic expectation of surgery, especially when they have arthritis. The doctor can explain you have arthritis and you have a meniscus tear and so you may or may not get better. It’s like a 50/50 chance you’ll get better. And if you do get better, you still may not be completely whole. But still patients just can’t get it through their mind that their knee is forever going to be different and they end up dissatisfied. The people who are highly satisfied are the ones who are back to their regular activities. The ones who are satisfied are back to most of their activities; and they’re pretty happy with that, but they still have some residual problems with their knees. The patients who are dissatisfied definitely say it wasn’t what they thought it was going to be, and they were not back to where they wanted to be at that time.” Primary Care Physician