Abstract
Purpose
The effect of knee cartilage defects that are detected during partial meniscectomy remains controversial in terms of the long-term prognosis on knee function. This study aimed to investigate the effect of concurrent medial compartment focal cartilage lesions on the long-term prognosis of knee function in patients who underwent arthroscopic partial medial meniscectomy for traumatic medial meniscal tears.
Methods
This retrospective study analyzed 46 patients who underwent arthroscopic partial medial meniscectomy between 1991 and 2008 by a single surgeon. Twenty-one patients who underwent arthroscopic partial medial meniscectomy due to traumatic meniscal tear had focal chondral lesions only at the medial compartment, and these patients were assigned to group A. Twenty-five patients who had no cartilage lesions in any compartments were assigned to group B. The age, sex, body mass index (BMI), follow-up time, age at the time of surgery, clinical and radiological scores, and perioperative arthroscopy findings were analyzed.
Results
The mean follow-up time was 20 ± 3.7 years. No significant difference was found in the demographic data, and the average age of the patients at the time of operation was 35 ± 9.5 years. Both groups had improved Lysholm score at the last follow-up. Although no difference was found between the groups during the preoperative period, group B had a higher Lysholm score at the last follow-up than group A. The mean International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS) scores at the last follow-up were significantly higher in group B. The mean Kellgren–Lawrence grades in the operated knees of group A were higher than those of group B. In group A, a negative correlation was found between the BMI and postoperative Lysholm (r = – 0.461, p = 0.03) IKDC (r = – 0.433, p = 0.05) and KOOS (r = – 0.565, p = 0.008) scores. In group B, no correlation was found between BMI and any score.
Conclusion
Among patients who underwent arthroscopic partial medial meniscectomy with an average follow-up of 20 years, those with concurrent focal cartilage defect in the medial compartment had clinically and radiologically worse outcomes than patients without any cartilage defect. Therefore, orthopedic surgeons should be meticulous before performing any arthroscopic partial medial meniscectomy in case of concurrent cartilage lesion.
Level of evidence
Level III.
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References
Abram SGF, Hopewell S, Monk AP, Bayliss LE, Beard DJ, Price AJ (2019) Arthroscopic partial meniscectomy for meniscal tears of the knee: A systematic review and meta-analysis. Br J Sports Med 54:652–663
Bolano LE, Grana WA (1993) Isolated arthroscopic partial meniscectomy. Functional radiographic evaluation at five years. Am J Sports Med 21:432–437
Eijgenraam SM, Reijman M, Bierma-Zeinstra SMA, van Yperen DT, Meuffels DE (2018) Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review. Br J Sports Med 52:514–521
Englund M, Lohmander LS (2004) Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum 50:2811–2819
Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549
Higuchi H, Kimura M, Shirakura K, Terauchi M, Takagishi K (2000) Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res 377:161–168
Hong SY, Han W, Jang J, Lee J, Ro DH, Lee MC, Han H-S (2022) Prognostic factors of mid- to long-term clinical outcomes after arthroscopic partial meniscectomy for medial meniscal tears. Clin Orthop Surg 14:227
Hulet CH, Locker BG, Schiltz D, Texier A, Tallier E, Vielpeau CH (2001) Arthroscopic medial meniscectomy on stable knees. J Bone Joint Surg 83-B:29–32
Hunter DJ, Guermazi A, Lo GH, Grainger AJ, Conaghan PG, Boudreau RM, Roemer FW (2011) Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthr Cartil 19:990–1002
Jørgensen U, Sonne-Holm S, Lauridsen F, Rosenklint A (1987) Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. J Bone Joint Surg Br 69:80–83
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
Kim J-Y, Bin S-I, Kim J-M, Lee B-S, Oh S-M, Cho W-J, Lee J-H (2020) Partial meniscectomy provides the favorable outcomes for symptomatic medial meniscus tear with an intact posterior root. Knee Surg Sports Traumatol Arthrosc 28:3497–3503
Maletius W, Messner K (1996) Chondral damage and age depress the long-term prognosis after partial meniscectomy. A 12- to 15-year follow-up study. Knee Surg Sports Traumatol Arthrosc 3:211–214
Maletius W, Messner K (1996) The effect of partial meniscectomy on the long-term prognosis of knees with localized, severe chondral damage. A twelve- to fifteen-year followup. Am J Sports Med 24:258–262
Markes AR, Hodax JD, Ma CB (2020) Meniscus Form and Function. Clin Sports Med Elsevier Inc 39:1–12
Matsusue Y, Thomson NL (1996) Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5- to 11-year follow-up study. Arthroscopy 12:39–44
McDermott I (2011) Meniscal tears, repairs and replacement: their relevance to osteoarthritis of the knee. Br J Sports Med 45:292–297
Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43B:752–757
Pujol N, Beaufils P (2019) Save the meniscus again! Knee Surg. Sports Traumatol. Arthrosc.
Razi M, Mortazavi SMJ (2020) Save the Meniscus, A good Strategy to Preserve the Knee. Arch Bone Jt Surg 8:1–4
Rockborn P, Gillquist J (1996) Long-term results after arthroscopic meniscectomy. The role of preexisting cartilage fibrillation in a 13 year follow-up of 60 patients. Int J Sports Med 17:608–613
Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Kalske J, Nurmi H, Kumm J, Sillanpää N, Kiekara T, Turkiewicz A, Toivonen P, Englund M, Taimela S, Järvinen T (2020) Arthroscopic partial meniscectomy for a degenerative meniscus tear: a 5 year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial. Br J Sports Med 54:1332–1339
Zhang T, Jauregui JJ, Foster M, Packer JD, Meredith SJ, Leong NL, Henn RF (2021) Outcomes of Partial Meniscectomy in Obese Patients: A Systematic Review and Meta-Analysis. Cartilage 13:216S-227S
Acknowledgements
Thanks to Prof. Dr. Hülya Ellidokuz for her help with statistics and thanks to Prof. Dr. Ali Balcı and Dr. Kürşat Şimşek for their help with radiological evaluation.
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ONE: Collecting data, evaluating patients on last follow-up, reviewing the literature, wrinting, editing. MA: Evaluating patients on last follow-up. AA: Writing, editing. HP: Owner of the idea, editing.
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Eroğlu, O.N., Asma, A., Armağan, M. et al. Ipsilateral chondral lesions worsen the long-term prognosis following arthroscopic partial medial meniscectomy. Knee Surg Sports Traumatol Arthrosc 31, 229–234 (2023). https://doi.org/10.1007/s00167-022-07086-0
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DOI: https://doi.org/10.1007/s00167-022-07086-0