Late results after arthroscopic partial medial meniscectomy

Abstract

In a retrospective study, 100 patients underwent a clinical and radiological follow-up examination after a minimum of 7 years (range 7.0-9.3 years) following an arthroscopic partial medial meniscectomy. None of these patients had associated intra-articular lesions, apart from minor chondral damage (max. grade 2 Outerbridge classification; < 1 cm2) of the medial compartment at the time of the primary arthroscopy. According to the modified Marshall score, the follow-up evaluation showed excellent clinical results in 96%. Nevertheless, the radiological outcome, as measured by comparing preoperative and postoperative X-rays, demonstrated a development or progression of the osteoarthritis of the affected knee joint in 33%, with a statistically significant correlation between the radiological and clinical outcomes (P< 0.05). The age of the patients at the time of operation and any angular deformity of the knee joint did not influence the radiological results. Women had a statistically significantly higher risk of developing gonarthrosis after partial medial meniscectomy than men (P < 0.05). The arthroscopic partial medial meniscectomy led to excellent subjective and functional results but could not prevent the increase or development of late degenerative changes in the medial knee compartment.

Retropatellar Chondromalacia Associated with Medial Osteoarthritis after Meniscus Injury

“…It is well known that the articular surfaces next to meniscal resection suff er from OA [6,8,11,39] . Only Englund and Lohmander [9] reported coexistent PF OA with the femorotibial OA in the same knee joint compartment 15-22 years aft er total meniscectomy.…”

“…Joint stability also depends on the intact meniscus [2] and propioception nerve endings have been observed inside the meniscal tissue [3] . It is known that femorotibial osteoarthritis (OA) appears aft er total meniscectomy [4] and even aft er partial removal in the same knee compartment [5][6][7][8] , aft er 15-22 years also in the patellofemoral (PF) compartment [9] and that successful repair can prevent OA [10] . Th e infl uence of the resection size on harm intensity and patient-relevant outcome is proven [11] .…”

Arthroscopic medial meniscectomy on stable knees

“…[9][10][11][12] The shortterm results have been good, 13 allowing early weightbearing, return of function, significantly reduced morbidity and reduction of the cost of care. 13 Reports of mediumterm follow-up 11,[14][15][16][17][18] have also been promising, but there are few long-term studies covering ten years or more. Other factors such as an associated rupture of the anterior cruciate ligament, contribute to a poor outcome.…”

Knee Muscle Strength After Recent Partial Meniscectomy Does Not Relate to 2-year Change in Knee Adduction Moment

“…After meniscectomy, patients are at increased risk of having knee osteoarthritis develop [22], particularly in the medial tibiofemoral compartment [18]. Knee osteoarthritis is, in part, considered a mechanical disease [10], with increased joint loading and knee muscle weakness thought to be important in disease pathogenesis [6].…”