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Clinical and radiographic results of arthroscopic partial lateral meniscectomies in stable knees with a minimum follow up of 20 years

Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope Submit manuscript

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Abstract

Purpose

The purpose of this retrospective multicentric study was to evaluate the long-term effects of lateral meniscectomy and to identify those patients who are at the most risk of developing osteoarthritis (OA).

Methods

Eighty-nine arthroscopic partial lateral meniscectomies in stable knees with a mean follow-up of 22 ± 3 years were included. The following influencing factors were analyzed: age, sex, body mass index (BMI), physical activity, alignment, the types of meniscal lesions, the extent of meniscal resections and the initially associated cartilage lesions. An independent examiner reviewed all patients, using subjective (KOOS and IKDC scores) and objective clinical and radiological evaluations (IKDC score). The contralateral knee was used as a reference to calculate the prevalence and the incidence of OA.

Results

The mean age at the time of surgery was 35 ± 13 years. The main location of the lesions was the mid-section of the lateral meniscus (79 % of the cases). At the latest follow-up, 48 % of the patients had an active lifestyle with as many as 48 % of the patients enjoying moderate to intense physical activity 22 years after the procedure (vs. 71 % before surgery). The KOOS score evolved from 82 to 69 % during the same period. The prevalence of OA was 56 % in the affected knee and the difference of prevalence between the operated and healthy knees was 44 %. In those patients presenting with an OA of the operated knee and a normal contralateral knee, the incidence of OA was 53 %. Predictors of OA were an age superior to 38 years at the time of surgery, obesity (BMI >30), and valgus malalignment as well as the presence of cartilage and degenerative meniscal lesions at the time of surgery.

Conclusion

In the long term, arthroscopic partial lateral meniscectomy in stable knees without initial cartilage lesions might yield good to excellent results in young patients. Patients are at higher risk to develop symptomatic OA if they are over 40, having a high BMI, valgus malalignment and cartilage lesions at the time of surgery. This study provides precise guidelines for the surgical treatment of lateral meniscus tears.

Level of evidence

IV.

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Acknowledgments

This study was performed under the patronage of the French Arthroscopic Society (SFA). The authors thank Pr. P. Neyret and Dr. E. Vargas (Lyon), Dr. J. Beldame and Dr. O. Charrois (Versailles), Dr. C. Javois and Dr. M. Boussaton (Toulouse), Dr. A. Wajsfisz and Dr. F. Lespagnol (Paris), Dr. Y. Acquitter (Rennes), Dr. B. Galaud (Caen) for their valuable contribution in patient reviewing and allowance to include them in this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Unit Comete INSERM U1075 UCBN EA3917, Orthopedic Department, Caen University Hospital, Caen Lower Normandy University, Caen, France

    Christophe Hulet

  2. Service de chirurgie orthopédique et traumatologie de l’appareil moteur, Unité d’orthopédie et traumatologie du sport, Swiss Olympic Medical Center, Hôpitaux Universitaires de Genève, Geneva, Switzerland

    Jacques Menetrey

  3. Department of Orthopedic Surgery, Centre Hospitalier de Versailles, Le Chesnay, France

    Philippe Beaufils

  4. Centre Orthopédique Santy, Lyon, France

    Pierre Chambat

  5. Cabinet Goethe, Paris, France

    Patrick Djian

  6. Hôpital Ambroise Paré CHU, Paris Ile de France Ouest, Paris, France

    Philippe Hardy

  7. Department of Orthopedic Surgery, Médipôle Garonne Toulouse, Toulouse, France

    Jean-François Potel

  8. Department of Orthopaedic Surgery, Hôpital de la Croix-Rousse, Lyon University Centre Albert Trillat, Lyon, France

    Elvire Servien

  9. Department of Orthopedic Surgery, Sports Medicine Research Laboratory, Public Research Center for Health, Centre Hospitalier Luxembourg, Luxembourg, Luxembourg

    Romain Seil

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  1. Christophe Hulet
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  2. Jacques Menetrey
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  3. Philippe Beaufils
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  4. Pierre Chambat
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  5. Patrick Djian
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  6. Philippe Hardy
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  7. Jean-François Potel
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  8. Elvire Servien
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  9. Romain Seil
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Consortia

The French Arthroscopic Society (SFA)

Corresponding author

Correspondence to Christophe Hulet.

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Hulet, C., Menetrey, J., Beaufils, P. et al. Clinical and radiographic results of arthroscopic partial lateral meniscectomies in stable knees with a minimum follow up of 20 years. Knee Surg Sports Traumatol Arthrosc 23, 225–231 (2015). https://doi.org/10.1007/s00167-014-3245-5

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