Arthroscopic partial and total meniscectomy: A long-term follow-up study with matched controls.

PURPOSE The purpose of this study was to compare the clinical and radiographic outcome of arthroscopic partial and total meniscectomy. TYPE OF STUDY Retrospective outcome study. METHODS Thirty-six male patients with stable knees, no previous knee injury, and arthroscopic meniscectomy were matched into 2 groups: partial or total. In addition, a group of individuals with no known history of knee injury was matched to each patient with meniscectomy. All patients were re-examined by a clinical and radiographic examination 14 years after surgery. RESULTS At follow-up, radiographic changes, including Fairbank changes and joint space narrowing, were seen in 6 of 18 patients (33%) after partial meniscectomy and in 13 of 18 patients (72%) after total meniscectomy (P <.05). Joint space narrowing >50% of the joint space was seen in 1 patient after partial meniscectomy but was present in 7 patients after total meniscectomy. In the healthy controls, 4 of 36 patients (11%) had radiographic changes but none had joint space narrowing. Fourteen years after surgery almost 70% of patients had a Lysholm score >94 (i.e., normal). Only 5 of 36 patients (14%) in the total meniscectomy group had knee symptoms during activities of daily living. A similar decline in activity levels according to Tegner was seen over time in the control group and in the 2 meniscectomy groups. CONCLUSIONS The frequency of radiographic changes 14 years after meniscectomy is related to the size of the meniscus removed, but the grades of these changes are low and have little influence on activity and knee function.

[1]  E. Larsen,et al.  The long term outcome of open total and partial meniscectomy related to the quantity and site of the meniscus removed , 1992, International Orthopaedics.

[2]  D B Kettelkamp,et al.  Factors effecting late results after meniscectomy. , 1974, The Journal of bone and joint surgery. American volume.

[3]  P. Walker,et al.  The role of the menisci in force transmission across the knee. , 1975, Clinical orthopaedics and related research.

[4]  T. Fairbank Knee joint changes after meniscectomy. , 1948, The Journal of bone and joint surgery. British volume.

[5]  E. Larsen,et al.  Partial versus total meniscectomy. A prospective, randomised study with long-term follow-up. , 1992, The Journal of bone and joint surgery. British volume.

[6]  I. Smillie Injuries of the Knee Joint , 1946, The Indian Medical Gazette.

[7]  J. Gillquist,et al.  A new modification of the technique of arthroscopy of the knee joint. , 1976, Acta chirurgica Scandinavica.

[8]  J. Lysholm,et al.  Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale , 1982, The American journal of sports medicine.

[9]  S. Ahlback,et al.  Osteoarthrosis of the knee. A radiographic investigation. , 1968 .

[10]  T. Fukubayashi,et al.  The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. , 1980, Acta orthopaedica Scandinavica.

[11]  J. Gillquist,et al.  Long Term Results After Arthroscopic Meniscectomy: The Role of Preexisting Cartilage Fibrillation in a 13 Year Follow-Up of 60 Patients , 1996, International journal of sports medicine.

[12]  E. Roos,et al.  Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. , 1998, Arthritis and rheumatism.

[13]  A Rosenklint,et al.  Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. , 1987, The Journal of bone and joint surgery. British volume.

[14]  B B Seedhom,et al.  Transmission of the Load in the Knee Joint with Special Reference to the Role of the Menisci Part I: Anatomy, Analysis and Apparatus , 1979 .

[15]  J. Lysholm,et al.  The correlation between osteoarthrosis as seen on radiographs and on arthroscopy. , 1987, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[16]  Freddie H. Fu,et al.  Meniscal tears: The effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee , 1986, The American journal of sports medicine.

[17]  T. Saxne,et al.  Postero-anterior radiogram of the knee in weight-bearing and semiflexion , 1997, Acta radiologica.

[18]  E M Tapper,et al.  Late results after meniscectomy. , 1969, The Journal of bone and joint surgery. American volume.

[19]  Freddie H. Fu,et al.  Peripheral tears of the meniscus , 1988, The American journal of sports medicine.

[20]  J. Lysholm,et al.  Instruments for routine arthroscopic surgery of the knee. , 1984, Acta chirurgica Scandinavica. Supplementum.

[21]  J. Ihn,et al.  In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy , 2004, International Orthopaedics.

[22]  C. Osgood,et al.  Semantic differential technique : a sourcebook , 1969 .

[23]  W. Glinz,et al.  Arthroscopic partial meniscectomy: a 12-year follow-up and two-step evaluation of the long-term course. , 1998, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[24]  J. Lysholm,et al.  Rating systems in the evaluation of knee ligament injuries. , 1985, Clinical orthopaedics and related research.