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Arthroscopy with partial meniscectomy for degenerative tear does not increase the risk of total knee arthroplasty at five year follow up; however, this population undergoes total knee arthroplasty with a lower threshold of osteoarthritis

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Abstract

Purpose

Degenerative meniscus tears can cause discomfort in some patients, and when medical treatments fail to provide relief, arthroscopy may be considered before resorting to knee prosthesis. However, the benefits of arthroscopy over nonsurgical treatments in patients over 60 years old are limited, and the evidence regarding its overall efficiency and drawbacks remains scarce. Furthermore, there has been no investigation into whether those patients treated with partial meniscectomy, undergo the knee operation at an earlier stage of osteoarthritis.

Methods

This study focused on data from a single Belgian hospital, involving patients over 60 years old with internal meniscal tears. The participants were categorized into two groups based on the treatment they received: arthroscopic partial meniscectomy (APM) or conservative management. The primary outcome assessed was the occurrence of knee arthroplasty within a five year period. Secondary outcomes included evaluating the ICRS cartilage grade and the time taken until total knee arthroplasty (TKA).

Results

A total of 194 patients with internal meniscal tears were included in the study. At the 5-year mark, the overall rate of knee arthroplasty was found to be 16.5%, with 11.9% of cases occurring within two years. After the 5-year follow-up, it was observed that 19.2% (24 patients) of the APM group and 11.6% (8 patients) of the conservative management group underwent knee arthroplasty. Notably, patients over 70 years old who underwent APM had a higher risk of eventually requiring TKA compared to those who received conservative management. Additionally, patients who underwent meniscectomy and later underwent TKA showed less wear in the internal compartment of the knee compared to patients in the conservative treatment group who underwent TKA.

Conclusion

The study suggests that patients who underwent arthroscopy faced a similar risk of knee arthroplasty compared to those who underwent conservative management, excepted for patients over 70 years old. Despite this similar risk of arthroplasty for the whole population, they exhibited lower osteoarthritis severity when compared to the conservative group.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Traumatology, EpiCURA Baudour Hornu Ath Hospital, Hainaut, Belgium

    Jacques Hernigou, Alexandre Hupez & Antoine Callewier

  2. Université libre de Bruxelles, Bruxelles, Belgium

    Jacques Hernigou & Dylan Lechien

  3. 2nd Department of Orthopaedic Surgery and Traumatology, Aristotle University of Thessaloniki, “G. Gennimatas” General Hospital, Thessaloniki, Hellas, Greece

    Theofylaktos Kyriakidis

  4. Department of Orthopaedic Surgery and Traumatology, A. Paré Hospital, Hainaut, Belgium

    Jérôme Valcarenghi

  5. Department of Anesthesia, EpiCURA Baudour Hornu Hospital, Hainaut, Belgium

    Aimée Muregancuro

Authors
  1. Jacques Hernigou
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  2. Dylan Lechien
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  3. Theofylaktos Kyriakidis
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  4. Jérôme Valcarenghi
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  5. Aimée Muregancuro
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  6. Alexandre Hupez
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  7. Antoine Callewier
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jacques Hernigou. The first draft of the manuscript was written by Jacques Hernigou and Dylan Lechien. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jacques Hernigou.

Ethics declarations

The ethics committee of the institution approved the study (P2023/032).

Conflict of interest

The authors declare no competing interests.

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J. Hernigou and D. Lechien are co-first authors.

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Hernigou, J., Lechien, D., Kyriakidis, T. et al. Arthroscopy with partial meniscectomy for degenerative tear does not increase the risk of total knee arthroplasty at five year follow up; however, this population undergoes total knee arthroplasty with a lower threshold of osteoarthritis. International Orthopaedics (SICOT) 48, 737–743 (2024). https://doi.org/10.1007/s00264-023-06024-0

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