American Board of Internal Medicine (ABIM) Certification Practice Exam

What is typically the primary treatment for acute meniscal tears in patients with significant mechanical symptoms?

1. Physical therapy

2. Rest and ice

3. Surgical intervention

4. Acetaminophen management

The correct answer is: Surgical intervention

The primary treatment for acute meniscal tears, especially in patients exhibiting significant mechanical symptoms such as locking, catching, or giving way of the knee, is surgical intervention. When these mechanical symptoms are prominent, they often indicate that the tear is likely to be complex or unstable, which typically does not respond adequately to conservative measures. Surgical options, such as arthroscopic meniscectomy or meniscal repair, aim to alleviate symptoms and restore normal knee function. The goal of surgery is to remove or repair the torn portion of the meniscus, thereby allowing for improved joint mechanics and reducing the risk of further complications that could arise from untreated meniscal injuries. While options like physical therapy, rest, ice, and acetaminophen management may be appropriate initial approaches in cases of minor tears or in less symptomatic patients, they do not address significant mechanical symptoms that can severely hinder daily activities and the overall function of the knee. In such cases, delaying surgical intervention could lead to further joint damage and complications in the long term, making surgical treatment the most effective choice for these patients.