Perimeniscal injections offer a promising new pathway in the conservative management of degenerative meniscus tears.
Degenerative meniscus tears are a common cause of persistent knee pain, especially in ageing and active populations. While physiotherapy and intra-articular injections remain mainstays of non-surgical care, a recent study by Prof. Cavaignac titled Redefining the gold standard in degenerative meniscus tear management—The rise of perimeniscal injections sheds light on a more targeted and potentially longer-lasting solution.
Conventional intra-articular corticosteroid injections offer only temporary relief, primarily because they fail to act on the precise site of inflammation: the meniscal periphery. This is where degenerative tears typically begin and where inflammatory mediators are most active.
Perimeniscal injections, guided by ultrasound, aim to deliver anti-inflammatory agents directly to the outer meniscal wall and adjacent synovial tissue. This approach is more anatomically targeted and addresses both the mechanical and biochemical factors contributing to the patient’s symptoms.
Importantly, the study references previous work by Coll et al. and Guenoun et al., which validated the accuracy of ultrasound-guided drug delivery around the meniscus. This technical precision is key to the observed improvements in patient outcomes.
The European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) has long emphasised the importance of physiotherapy in managing degenerative meniscal conditions. Perimeniscal injections do not undermine this approach, they enhance it.
By mitigating pain more effectively and rapidly than traditional methods, these injections improve patient adherence to rehabilitation protocols. Patients can engage earlier and more comfortably in exercises aimed at strengthening, mobilisation and neuromuscular retraining. In challenging subgroups, such as those with effusion or advanced osteoarthritis (Kellgren-Lawrence grade > III), this combined strategy has even been shown to delay the need for surgery.
Perhaps the most striking finding of the study is the durability of results. Five years after receiving a perimeniscal injection, 52% of patients did not require a second one. Functional recovery, as assessed by Tegner activity scores, was comparable to outcomes observed after partial meniscectomy.
This durability translates into economic value. The treatment offers a compelling case for inclusion in value-based care models by reducing repeat interventions and potentially avoiding or delaying surgical procedures.
In this context, perimeniscal injections appear to bridge the gap between simple symptom control and true functional restoration, offering a middle ground between conservative and surgical options.
Perimeniscal injections represent a paradigm shift in the conservative management of degenerative meniscus tears. By delivering treatment precisely where it is needed and enhancing physiotherapy outcomes, they are redefining what we consider the “gold standard” in non-operative care.
If you’re looking for expert assessment or advice for your knee condition, we highly recommend consulting Professor Etienne Cavaignac, a recognised leader in knee surgery and conservative orthopaedic treatments.
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