American Board of Internal Medicine (ABIM) Certification Practice Exam

Persistent mechanical symptoms in acute meniscal tears may require what intervention?

1. Physical therapy

2. Immediate surgery

3. Surgical intervention consideration

4. Complete immobilization

The correct answer is: Surgical intervention consideration

In cases of acute meniscal tears, persistent mechanical symptoms such as locking, catching, or significant instability in the knee can indicate that non-surgical interventions may not be sufficient to address the problem. Surgical intervention consideration is appropriate in these scenarios because the meniscus plays a critical role in knee stability and function. If conservative management options like rest, ice, physical therapy, or immobilization fail to alleviate symptoms, it may be necessary to explore surgical options. Surgical intervention can involve repairing the meniscus if possible or, in cases where repair is not feasible, performing a partial meniscectomy to remove the damaged portion. This approach aims to restore functionality and reduce pain, allowing for better outcomes. Physical therapy may be initially attempted, especially to strengthen surrounding musculature and improve range of motion, but if persistent symptoms remain, surgery becomes a more likely option. Immediate surgery is not always warranted without prior assessment and could lead to unnecessary procedures. Complete immobilization is generally not a recommended long-term strategy as it can lead to stiffness and loss of function. Therefore, considering surgical intervention when mechanical symptoms persist is a rational approach in managing acute meniscal tears.