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Meniscal tear morphology independently affects pain relief following arthroscopic partial meniscectomy in middle-aged patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To analyze the influence of meniscal tear pattern on clinical outcomes following arthroscopic partial meniscectomy in middle-aged patients with medial meniscal tears.

Methods

A total of 123 patients (130 knees) aged ≥ 50 years who underwent arthroscopic partial meniscectomy for medial meniscal tears were evaluated. Inclusion criteria were none to moderate medial knee osteoarthritis [Kellgren–Lawrence (KL) grade ≤ 3] and a minimum of 2-year follow-up (median 4.6 years; range 2.1–8.0 years). Meniscal tears observed during arthroscopic examination were classified into six types: radial tear of the middle segment, posterior root tear, horizontal tear of the posterior segment, flap tear, minor tear, and complex tear. Postoperative outcomes were classified into effective (group 1) and non-effective (group 2) according to the pain relief administered 1 month postoperatively and at the final follow-up. Demographic variables, KL grade, type of meniscal tear, and postoperative follow-up period were evaluated.

Results

Forty knees (38%) were classified into group 1. Of the six types of tears, radial tear of the middle segment [odds ratio (OR) 4.1, 95% confidence interval (CI) 1.1–20.9] and flap tear (OR 12.9, 95% CI 1.8–140.7) were significant predictors of good outcome on multivariate logistic regression analysis.

Conclusions

In middle-aged patients with medial meniscal tears, radial tear of the middle segment was independently associated with less pain following arthroscopic meniscectomy. Arthroscopic partial meniscectomy may be indicated in patients with radial tear if conservative treatment fails.

Level of evidence

Case–control study, Level III.

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Fig. 1

(adapted with permission from Springer Publishing Company [22])

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Funding

No financial support, interests or benefits from commercial sources were provided for the work reported on the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Masayuki Kamimura, Atsushi Takahashi, Yu Mori, Daisuke Chiba, Yoshiyuki Kuwahara & Eiji Itoi

  2. Omagari Orthopaedic Clinic, 11-6-8 Ohana-cho, Daisen, Akita, 014-0022, Japan

    Jutaro Umehara

Authors
  1. Masayuki Kamimura
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  2. Jutaro Umehara
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  3. Atsushi Takahashi
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  4. Yu Mori
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  5. Daisuke Chiba
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  6. Yoshiyuki Kuwahara
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  7. Eiji Itoi
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Corresponding author

Correspondence to Masayuki Kamimura.

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The authors declare that they have no conflict of interest.

Ethical approval

The present study was conducted with prior approval of the Ethical Committee of Omagari Kosei Medical Center.

Informed consent

Informed consent was obtained from all participants included in the study.

Appendix

Appendix

See Table 5.

Table 5 Univariate analysis of the effectiveness of arthroscopic partial meniscectomy
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Kamimura, M., Umehara, J., Takahashi, A. et al. Meniscal tear morphology independently affects pain relief following arthroscopic partial meniscectomy in middle-aged patients. Knee Surg Sports Traumatol Arthrosc 27, 2460–2467 (2019). https://doi.org/10.1007/s00167-018-5238-2

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