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The frequency of cartilage lesions in non-injured knees with symptomatic meniscus tears: results from an arthroscopic and NIR- (near-infrared) spectroscopic investigation

Archives of Orthopaedic and Trauma Surgery volume 137, pages 837–844 (2017)Cite this article

Abstract

Introduction

Are symptomatic tear injuries to the menisci of the knee frequently or always associated with cartilage damage to the corresponding articular surfaces and other joint surfaces, respectively?

Methods

A total of 137 patients (medial n = 127; lateral n = 10) underwent a meniscus resection. These patients showed no signs of a clear radiographic arthrosis and no MRI-detectable cartilage lesions > grade II. Traumatic injury was ruled out with a thorough medical history. The indication for operation was made exclusively on the basis of distinct, clinically apparent meniscus signs. In addition to the ICRS classification, all articular surfaces were examined spectroscopically (NIRS, near-infrared spectroscopy).

Results

In 76.6% (n = 105) of all knees examined, clear cartilage damage (ICRS-grade III/IV) was found. For 43.8%, these were in the area of the patella, while for 34.3% they were in the area of the medial femur, and for 17.5%, in the area of the medial tibial plateau. More rarely, this damage was localized to the area of the trochlea (8.8%) or the lateral joint compartment (femoral 2.2%, tibial 15.3%). There were no significant differences between patients with medial or lateral meniscus lesions with respect to the distribution pattern of the joint injuries. During spectroscopic examination, pathological values were demonstrated (objective evidence of cartilage degeneration) in at least one of the examined articular surfaces (media n = 6, range 1–6).

Conclusion

Through our investigations, a high, if not complete, concomitance of degenerative cartilage lesions and degenerative meniscus damage was demonstrated. From this it can be concluded that the entity of “isolated degenerative meniscus damage” clearly does not exist in practice. It is therefore highly probable that degenerative meniscus lesions, as a part of general joint degeneration, are to be interpreted in the context of the development of arthrosis. The practical consequences still are unclear. Patients after partial meniscectomy need a longer follow-up to detect potential cartilage lesions as well as an OA progression.

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Author information

Affiliations

  1. Center of Trauma and Orthopedic Surgery Eisenach, Sophienstr. 16, 99817, Eisenach, Germany

    Gunter Spahn

  2. Arthroscpec GmbH in Liquidation, Jena, Germany

    Holger Plettenberg & Martin Hoffmann

  3. FIMB Bayreuth, Bayreuth, Germany

    Holm-Torsten Klemm

  4. REPAIR-lab, Institute of Pathology, University of Regensburg, Regensburg, Germany

    Christoph Brochhausen-Delius

  5. Trauma Center Bergmannstrost Halle, Halle, Germany

    Gunther O. Hofmann

  6. Jena University Hospital, Trauma Center, Jena, Germany

    Gunter Spahn & Gunther O. Hofmann

Authors
  1. Gunter Spahn
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  2. Holger Plettenberg
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  3. Martin Hoffmann
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  4. Holm-Torsten Klemm
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  5. Christoph Brochhausen-Delius
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  6. Gunther O. Hofmann
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Correspondence to Gunter Spahn.

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Spahn, G., Plettenberg, H., Hoffmann, M. et al. The frequency of cartilage lesions in non-injured knees with symptomatic meniscus tears: results from an arthroscopic and NIR- (near-infrared) spectroscopic investigation. Arch Orthop Trauma Surg 137, 837–844 (2017). https://doi.org/10.1007/s00402-017-2672-4

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  • DOI: https://doi.org/10.1007/s00402-017-2672-4

Keywords

  • Knee
  • Cartliage
  • Meniscus
  • Arthroscopy
  • NIRS
  • Spectroscopy