Arthroscopic partial meniscectomy: A long-term follow-up

Faunø, Peter; Nielsen, Anne Ellerup

doi:10.1016/0749-8063(92)90066-k

Cited by 168 publications

(109 citation statements)

References 20 publications

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“…Noble and Hamblen also found an association between horizontal cleavages and osteoarthritic changes (Noble and Hamblen 1975). The worse outcome of the degenerative type of tear is consistent with previous observations from my department and from other groups (Faunø and Nielsen 1992, Neyret et al 1994, Roos et al 1995, Chatain et al 2003.…”

Section: Type Of Meniscal Tear Largely Determines the Long-term Outcomesupporting

confidence: 80%

“…However, most reports of partial meniscectomy, including the only prospective study (Hede et al 1992), have failed to demonstrate, or presented only very limited evidence, of a lower frequency of radiographic knee OA or functional improvements (Faunø and Nielsen 1992, Neyret et al 1993, Burks et al 1997, Higuchi et al 2000, Andersson-Molina et al 2002. In addition to the limitations associated with the reports after total meniscectomy, previous studies may have been affected by the use of short follow-up times, lack of adjustment for BMI, low patient numbers, and the patient-relevant outcome has been inadequately evaluated.…”

Section: Partial Meniscectomy-less Radiographic Changesmentioning

confidence: 99%

“…However, despite numerous follow-up reports, the evidence of an improved long-term outcome is still limited compared with total extirpation (Faunø and Nielsen 1992, Neyret et al 1993, Burks et al 1997, Higuchi et al 2000, Andersson-Molina et al 2002. The only prospective study failed to detect signifi cant benefi t with respect to radiographic changes of partial compared with total meniscectomy (Hede et al 1992a).…”

Section: Partial Meniscectomymentioning

confidence: 99%

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Meniscal tear - a feature of osteoarthritis

Englund¹

2004

SORT

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Meniscectomy is recognized as an important risk factor for the development of knee osteoarthritis (OA), a disease that traditionally has been considered as a simple "wear and tear" phenomenon. However, despite numerous reports, little evidence has been presented that a limited meniscal resection, compared with a more extensive resection, reduces the risk of OA by preserving meniscal function. Why? This thesis provides one possible answer to that question.Patients, who had undergone isolated meniscal resection in 1973, 1978, or between 1983 and 1985 at Lund University Hospital, Sweden, were reviewed clinically and radiographically 15-22 years after the surgical procedure.Of the subjects (n = 317) almost 50% had developed radiographic OA in their operated knee, but just over half of these patients were symptomatic. An additional 20% of the patients had knee symptoms, but did not have radiographic knee OA. These results confi rm a limited correlation between radiographic features of the disorder and symptoms.A degenerative type of meniscal tear and obesity were the factors most strongly associated with both radiographic knee OA and symptomatic radiographic knee OA.Partial meniscal resection induced less radiographic changes related to knee OA compared with total meniscectomy, but the patient-relevant outcomes remained essentially the same.If radiographic hand OA was present there was an increased likelihood of the patient also having knee OA following meniscectomy. This fi nding was independent of age, and therefore an inherited susceptibility to the disease contributes to the risk of knee OA after meniscal tear. Genetic and environmental risk factors interact in OA development.A degenerative meniscal lesion is often associated with early-stage knee OA, a disorder also involving the meniscal tissue. The tear may thus represent the fi rst "signal" feature of OA. The challenge for the health professional is to discriminate between symptoms caused by a meniscal tear and those caused by OA. Meniscal resection may not benefi t the patient with early-stage knee OA. The intervention merely removes evidence of the disorder, while the OA joint degradation proceeds.

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Section: Type Of Meniscal Tear Largely Determines the Long-term Outcomesupporting

confidence: 80%

Section: Partial Meniscectomy-less Radiographic Changesmentioning

confidence: 99%

Section: Partial Meniscectomymentioning

confidence: 99%

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Meniscal tear - a feature of osteoarthritis

Englund¹

2004

SORT

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“…For this reason, partial meniscectomy has historically been the mainstay of surgical treatment for normal meniscal tears. Despite the benefits of short-term pain relief, partial meniscectomy has been associated with a substantially increased incidence of progressive degenerative changes [18][19][20][21][22][23][24][25][26][27] . This finding has emphasized the importance of meniscal preservation whenever feasible.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, degenerative changes associated with meniscectomies have been linked to increased joint contact stress (hereafter referred to as contact pressure) in the adjacent articular cartilage as measured in vitro [18][19][20][21][22][23][24][25][26][27] . To date, however, experimental models have been primarily conducted under static or quasi-static uniaxial loading conditions 8,[28][29][30][31][32][33] .…”

mentioning

confidence: 99%

Dynamic Contact Mechanics of the Medial Meniscus as a Function of Radial Tear, Repair, and Partial Meniscectomy

Bedi

Kelly

Baad

et al. 2010

The Journal of Bone and Joint Surgery-American Volume

260

212

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Knee osteoarthritis after meniscectomy: Prevalence of radiographic changes after twenty-one years, compared with matched controls

Roos

Lauren²,

Adalberth

et al. 1998

Arthritis & Rheumatism

648

415

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Objective. To study the long-term outcome of surgical removal of a meniscus in the knee with regard to radiographic signs of osteoarthritis (OA). Methods. Of the 123 patients who underwent an open meniscectomy due to an isolated meniscus tear in 1973 at Lund University Hospital, 107 were followed up 21 years later by clinical examination and by review of knee radiographs obtained with weight bearing. Seventy-nine of the 107 patients were men, and the mean age of the total study group at examination was 55 years (range 35-77). Sixty-eight sex-and age-matched individuals with healthy knees sewed as controls. Results. Mild radiographic changes were found in 76 (71%) of the knees, while more advanced changes, comparable with a Kellgren-Lawrence grade of 2 or higher, were seen in 51 (48%). The corresponding prevalence values in the control group were 12 (18%) and 5 (7%), respectively. The relative risk for the presence of the more advanced radiographic changes representing definite radiographic tibiofemoral OA was 14.0 (95% confidence intewal 3.5-121.2), using age-and sex-matched pairs for comparison. No correlation with sex, localization to compartment, type of meniscus tear,

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Arthroscopic partial meniscectomy: A long-term follow-up

Cited by 168 publications

References 20 publications

Meniscal tear - a feature of osteoarthritis

Meniscal tear - a feature of osteoarthritis

Dynamic Contact Mechanics of the Medial Meniscus as a Function of Radial Tear, Repair, and Partial Meniscectomy

Knee osteoarthritis after meniscectomy: Prevalence of radiographic changes after twenty-one years, compared with matched controls

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