Meniscus Injuries Medication

  • Author: Bradley S Baker, MD; Chief Editor: Craig C Young, MD   more...
 
Updated: Mar 22, 2011
 

Medication Summary

Medical therapy is used in the treatment of meniscal injuries. It can be used during trials of nonoperative management with associated rest, ice, and a rehabilitation program. If surgical treatment is indicated, medical therapy is valuable in postoperative management.

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Nonsteroidal anti-inflammatory drugs

Class Summary

NSAIDs are a first-line medical therapy. The goal with the use of these agents is to reduce pain and inflammation during early attempts at conservative management of meniscal tears or during the postoperative period following surgical treatment. Myriad drugs are available. A few are listed below, including the newer cyclooxygenase (COX)-2 inhibitors. The COX-2 inhibitors are more specifically directed at inflammation and pain without the gastrointestinal (GI) toxicity.

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Ibuprofen (Motrin, Ibuprin)

 

DOC for mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

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Celecoxib (Celebrex)

 

Inhibits primarily COX-2, which is considered an inducible isoenzyme; induced during pain and inflammatory stimuli. Inhibition of COX-1 may contribute to NSAID GI toxicity. At therapeutic concentrations, COX-1 isoenzyme is not inhibited; thus, GI toxicity may be decreased. Seek lowest dose for each patient.

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Analgesics

Class Summary

Analgesics are an alternative therapy to NSAIDs with similar indications. These agents are directed primarily at controlling pain and do not have an anti-inflammatory effect.

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Acetaminophen (Tylenol, Feverall, Aspirin-Free Anacin)

 

DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants.

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Narcotic analgesics

Class Summary

Narcotic analgesics should be used sparingly in the conservative treatment period. The use of these agents is warranted only in special cases in which intolerable pain is present that cannot be controlled by the first-line drugs. However, these drugs are commonly used in the postoperative period when surgical treatment is necessary. Many options are available, and narcotic analgesics are commonly combined with drugs from the above categories. Common examples are listed.

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Hydrocodone and acetaminophen (Vicodin, Lortab, Norcet)

 

Drug combination for moderate to severe pain.

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Oxycodone (Roxicodone, OxyContin, OxyIR)

 

Indicated for moderate to severe pain.

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Contributor Information and Disclosures
Author

Bradley S Baker, MD  Clinical Professor, Department of Orthopedic Surgery and Orthopedic Sports Medicine, Sanford School of Medicine, University of South Dakota; Orthopedic Consultant/Team Physician, Sanford Sports Medicine

Bradley S Baker, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Sports Medicine, American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and Mid-America Orthopaedic Association

Disclosure: Nothing to disclose.

Coauthor(s)

James Lubowitz, MD  Director, Taos Orthopedic Institute, Holy Cross Hospital of Taos; Clinical Professor, Department of Orthopedic Surgery, University of New Mexico

James Lubowitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and Arthroscopy Association of North America

Disclosure: Arthrex Consulting and royalty Consulting; Smith and Nephew Consulting fee Consulting; Breg Grant/research funds Other

Specialty Editor Board

Leslie Milne, MD  Assistant Clinical Instructor, Department of Emergency Medicine, Harvard University School of Medicine

Leslie Milne, MD is a member of the following medical societies: American College of Sports Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Henry T Goitz, MD  Academic Chair and Associate Director, Detroit Medical Center Sports Medicine Institute; Director, Education, Research, and Injury Prevention Center; Co-Director, Orthopaedic Sports Medicine Fellowship

Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD  Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Director of Primary Care Sports Medicine Fellowship, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, and Phi Beta Kappa

Disclosure: Nothing to disclose.

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