How to manage the patient with a degenerative meniscal tear? Prof Mark Hutchinson (USA)

Professor Mark Hutchinson, University of Chicago, Illinois, is an international leader in Orthopaedics and Sports Medicine. He has worked closely with the US Olympic Committee by serving at the Training Centre in Colorado and being part of Team USA at the Pan American Games in Canada (2015). In this first of two podcasts, he discusses management of the patient who presents with recent onset of acute knee pain. You might be surprised by some of what this orthopaedic surgeon says! Timeline 1:30m - Importance of a broad clinical workup 2:23m - In the arthritic knee, arthroscopy does not improve patient outcomes. 3:00m - Arthroscopy versus physiotherapy in MRI proven degenerative meniscal tears: no difference 3:30m - What about when there are mechanical symptoms such as ‘locking’ or ‘giving way’? Prof Hutchinson says these may warrant a surgical referral. 4:30m - What would most orthopaedic surgeons do when faced with our clinical scenario? 5:30m - How long should the patient /physiotherapist persist with conservative management? What are the indications for arthroscopy? “Arthroscopy generally doesn’t treat arthritis”. Links: Two previous podcasts on BJSM podcasts Pearls on knee examination: http://ow.ly/UBy3v Pearls on shoulder examination plus one wrist bonus: http://ow.ly/UBym8 Mark's YouTube videos on Physical Examination have been viewed more than 5 million times! https://www.youtube.com/user/BJSMVideos

Next week: (2nd podcast) a patient presents after rupturing her/his ACL. Does she/he need a knee reconstruction and what are the issues about return to play?