Skip to main content
SpringerLink
Log in

Partial Meniscectomy and Osteoarthritis

Implications for Treatment of Athletes

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Summary

The biphasic ultrastructure of the meniscus and of articular cartilage provides their function in the complex biomechanics of the knee joint including load distribution, shock absorption, viscoelasticity, a smooth low friction gliding surface and resilience to compression. Meniscectomy may lead to destruction of cartilage and to osteoarthritis of the knee joint. Osteoarthritic changes after meniscectomy have been reported in up to 89% of patients.

Retrospective analysis after open or arthroscopically assisted meniscectomy revealed restriction in sports to be between 2 and 50% and cessation of sports to be between 2 and 25%. Generally, patients with degenerative changes at the time of surgery are reported to have lower knee joint function and to resume sports activities later.

Pharmalogical measures to treat osteoarthritis following previous meniscectomy include pain medication and intra-articular drug administration. Additionally, range of motion and strengthening exercises and moderate athletic activities are recommended. When surgery is considered, correctional osteomies and uni-compartmental or total knee arthroplasty depending on the degree of osteoarthritis are preferred.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Walker PS, Erkman MJ. The role of the menisci in force transmission across the knee. Clin Orthop 1975; 109: 184–92

    Article  PubMed  Google Scholar 

  2. Krause WR, Pope MH, Johnson RJ, et al. Mechanical changes in the knee after meniscectomy. J Bone Joint Surg Am 1976; 58-A: 599–604

    Google Scholar 

  3. Markolf KL, Mensch JS, Amstutz HC. Stiffness and laxity of the knee. The contributions of the supporting structures. J Bone Joint Surg Am 1976; 58-A: 583–94

    Google Scholar 

  4. Cox JS, Cordell LD. The degenerative effects of medial meniscus tears in dogs’ knees. Clin Orthop 1977, 125: 236–42

    PubMed  Google Scholar 

  5. Jones RE, Smith EC, Reisch JS. Effects of medial meniscectomy in patients older than forty years. J Bone Joint Surg Am 1978; 60-A: 783–6

    Google Scholar 

  6. Seedhom BB, Hargreaves DJ. Transmission of the load in the knee joint with special reference to the role of the menisci. II. Experimental results, discussion and conclusions. Eng Med 1979; 8: 220–8

    Google Scholar 

  7. Kurosawa H, Fukubayashi T, Nakajima H. Load-bearing mode of the knee joint. Clin Orthop 1980; 149: 283–90

    PubMed  Google Scholar 

  8. Sonne-Holm S, Fledelius I, Ahn NC. Results after meniscectomy in 147 athletes. Acta Orthop Scand 1980; 51: 303–9

    Article  PubMed  CAS  Google Scholar 

  9. Noble J, Turner PG. The function, pathology, and surgery of the meniscus. Clin Orthop 1986; 210: 62–8

    PubMed  Google Scholar 

  10. McBride ID, Reid JG. Biomechanical considerations of the menisci of the knee. Can J Sport Sci 1988; 13: 175–87

    PubMed  CAS  Google Scholar 

  11. McDevitt CA, Webber RJ. The ultrastructure and biochemistry of meniscal cartilage. Clin Orthop 1989; 252: 8–18

    Google Scholar 

  12. Fithian DC, Kelly MA, Mow VC. Material properties and structure-function relationships in the menisci. Clin Orthop 1990; 252: 19–31

    PubMed  Google Scholar 

  13. Fu FH, Thompson WO. Biomechanics and kinematics of meniscus. In: Finerman GAM, Noyes FR, editors. Biology and biomechanics of the traumatized synovial joint: the knee as a model [workshop]. Rosemont (H): American Academy of Orthopedic Surgeons, 1992: 153–83

    Google Scholar 

  14. Rangger C, Glötzer W, Benedetto KP. Ligamentous instability following partial arthroscopic medial meniscectomy [in German]. Unfallchirurg 1994; 97: 435–7

    PubMed  CAS  Google Scholar 

  15. Mow VC, Ateshian GA, Ratcliffe A. Anatomic form and biomechanical properties of articular cartilage of the knee joint. In: Finerman GAM, Noyes FR, editors. Biology and biomechanics of the traumatized synovial joint: the knee as a model [workshop]. Rosemont (II): American Academy of Orthopedic Surgeons, 1992: 55–81

    Google Scholar 

  16. Mow VC, Kuei SC, Lai WM, et al. Biphasic creep and stress relaxation of articular cartilage in compression: theory and experiments. J Biomech Eng 1980; 102: 73–84

    Article  PubMed  CAS  Google Scholar 

  17. Fairbank TJ. Knee joint changes after meniscectomy. J Bone Joint Surg Br 1948; 30-B: 664–70

    Google Scholar 

  18. Streli R. Spätergebnisse nach partieller Meniskusresektion bei 82 Fällen. Der Chirurg 1955; 3: 97–103

    Google Scholar 

  19. Huckel JR. Is meniscectomy a benign procedure? A long-term follow-up study. Can J Surg 1965; 8: 254–60

    Google Scholar 

  20. Gear WL. The late results of meniscectomy. Br J Surg 1967; 54: 270–2

    Article  PubMed  CAS  Google Scholar 

  21. Jackson JP. Degenerative changes in the knee after meniscectomy. J Bone Joint Surg Br 1967; 49-B: 584

    Google Scholar 

  22. Jackson JP. Degenerative changes in the knee after meniscectomy. BMJ 1968; 2: 525–7

    Article  PubMed  CAS  Google Scholar 

  23. Ahlbäck S. Osteoarthrosis of the knee: a radiographic investigation. Acta Radiol Diagn Stockh 1968; 277 Suppl.: 7–72

    Google Scholar 

  24. Tapper EM, Hoover NW. Late results after meniscectomy. J Bone Joint Surg Am 1969; 51-A: 517–26

    Google Scholar 

  25. Appel H. Late results after meniscectomy in the knee joint: a clinical and radiological follow-up investigation. Acta Orthop Scand Suppl 1970; 133: 1–111

    PubMed  CAS  Google Scholar 

  26. Johnson RJ, Kettelkamp DB, Clark W, et al. Factors affecting late results after meniscectomy. J Bone Joint Surg Am 1974; 56-A: 719–29

    Google Scholar 

  27. Dandy DJ, Jackson RW. The diagnosis of problems after meniscectomy. J Bone Joint Surg Br 1975; 57-B: 349–52

    Google Scholar 

  28. Dandy DJ, Jackson RW. Meniscectomy and chondromalacia of the femoral condyle. J Bone Joint Surg Am 1975; 57-A: 1116–9

    Google Scholar 

  29. Jones RE, Smith EC, Reisch JS. Effects of medial meniscectomy in patients older than forty years. J Bone Joint Surg Am 1978; 60-A: 783–6

    Google Scholar 

  30. Fox JM, Blazina ME, Carlson GJ. Multiphasic view of medial meniscectomy. Am J Sports Med 1979; 7: 161–4

    Article  PubMed  CAS  Google Scholar 

  31. Yocum LA, Kerlan RK, Jobe FW, et al. Isolated lateral meniscectomy. J Bone Joint Surg Am 1979; 61-A: 338–42

    Google Scholar 

  32. Allen PR, Denham RA, Swan AV. Late degenerative changes after meniscectomy. J Bone Joint Surg Br 1984; 66-B: 666–71

    Google Scholar 

  33. Jorgensen U, Sonne-Holm S, Lauridsen F, et al. Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. J Bone Joint Surg Br 1987; 69-B: 80–3

    Google Scholar 

  34. Soballe K, Hansen AJ. Late results after meniscectomy in children. Injury 1987; 18: 182–4

    Article  PubMed  CAS  Google Scholar 

  35. Covall DJ, Wasilewski SA. Roentgenographic changes after arthroscopic meniscectomy: five-year follow-up in patients more than 45 years old. Arthroscopy 1992; 8: 242–6

    Article  PubMed  CAS  Google Scholar 

  36. Fauno P, Nielsen AB. Arthroscopic partial meniscectomy: a long-term follow-up. Arthroscopy 1992; 8: 345–9

    Article  PubMed  CAS  Google Scholar 

  37. Bolano LE, Grana WA. Isolated partial meniscectomy. Functional radiographic evaluation at five years. Am J Sports Med 1993; 21: 432–7

    Article  PubMed  CAS  Google Scholar 

  38. Rangger C, Klestil T, Glötzer W, et al. Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 1995: 23: 240–4

    Article  PubMed  CAS  Google Scholar 

  39. Lanzer WL, Komenda G. Changes in articular cartilage after meniscectomy. Clin Orthop 1990; 252: 41–8

    PubMed  Google Scholar 

  40. Mehraban F, Kuo SY, Riera H, et al. Prostromelysin and procollagenase genes are differentially up-regulated in chondrocytes from the knees of rabbits with experimental osteoarthritis. Arthritis Rheum 1994; 37: 1189–97

    Article  PubMed  CAS  Google Scholar 

  41. Fahmy NRM, Williams EA, Noble J. Meniscal pathology and osteoarthritis of the knee. J Bone Joint Surg Br 1983; 65-B: 24–8

    Google Scholar 

  42. Northmore-Ball MD, Dandy DJ, Jackson RW. Arthroscopic, open partial, and total meniscectomy. J Bone Joint Surg Br 1983; 65-B: 400–4

    Google Scholar 

  43. Hoshikawa Y, Kurosawa H, Fukubayashi T, et al. The prognosis of meniscectomy in athletes. Am J Sports Med 1983; 11:8–13

    Article  PubMed  CAS  Google Scholar 

  44. Katz JN, Harris TM, Larson MG, et al. Predictors of functional outcomes after arthroscopic partial meniscectomy. J Rheumatol 1992; 1938-42

  45. Wouters E, Bassett FH, Hardaker WT, et al. An algorithm for arthroscopy in the over-50 age group. Am J Sports Med 1992; 20: 141–5

    Article  PubMed  CAS  Google Scholar 

  46. Bonamo JJ, Kessler KJ, Noah J. Arthroscopic meniscectomy in patients over the age of 40. Am J Sports Med 1992; 20: 422–9

    Article  PubMed  CAS  Google Scholar 

  47. Osti L, Liu SH, Raskin A, et al. Partial lateral meniscectomy in athletes. Arthroscopy 1994; 10: 424–30

    Article  PubMed  CAS  Google Scholar 

  48. Bagnolesi P, Cilotti A, Campassi C, et al. Radiologie assessment of the knee after meniscectomy [in Italian]. Radiol Med (Torino) 1995; 90: 194–201

    CAS  Google Scholar 

  49. Matsusue Y, Thomson NL. Arthroscopic partial meniscectomy in patients over 40 years old: a 5 to 11 year follow-up study. Arthroscopy 1996; 12: 39–44

    Article  PubMed  CAS  Google Scholar 

  50. Boszotta H, Helperstorfer W, Kölndorfer G, et al. The long-term results after arthroscopic meniscectomy [in German]. Aktuelle Traumatol 1994; 24: 30–4

    PubMed  CAS  Google Scholar 

  51. Chantraine A. Knee joint in soccer players: osteoarthritis and axis deviation. Med Sci Sports Exerc 1985; 17: 434–9

    Article  PubMed  CAS  Google Scholar 

  52. Howe J, Johnson RJ. Knee injuries in skiing. Orthop Clin North Am 1985; 16: 303–14

    PubMed  CAS  Google Scholar 

  53. Baker BE, Peckham AC, Pupparo F, et al. Review of meniscal injury and associated sports. Am J Sports Med 1985; 13: 1–4

    Article  PubMed  CAS  Google Scholar 

  54. Neyret P, Donell ST, Dejour D, et al. Partial meniscectomy and anterior cruciate ligament rupture in soccer players. Am J Sports Med 1993; 21: 455–60

    Article  PubMed  CAS  Google Scholar 

  55. Whipple TL, Caspari RB, Meyers JF. Arthroscopic meniscectomy. An interim report at three to four years after operation. Clin Orthop 1984; 183: 105–14

    PubMed  Google Scholar 

  56. Hamberg P, Gillquist J. Knee function after arthroscopic meniscectomy. Acta Orthop Scand 1984; 55: 172–5

    Article  PubMed  CAS  Google Scholar 

  57. Simpson DA, Thomas NP, Aichroth PM. Open and closed meniscectomy. J Bone Joint Surg Br 1986; 68-B: 301–4

    Google Scholar 

  58. Gillquist J, Oretorp N. Arthroscopic partial meniscectomy. Clin Orthop 1982; 167: 29–33

    PubMed  Google Scholar 

  59. Ogilvie-Harries DJ, Bauer M, Correy P. Prostaglandin inhibition and the rate of recovery after arthroscopic meniscectomy. J Bone Joint Surg Br 1985; 67-B: 567–71

    Google Scholar 

  60. Drez D, Ritter M, Rosenberg T. Pain relief after arthroscopy: naproxen sodium compared to propoxyphene napsylate with acetominophen. South Med J 1987; 80: 440–3

    Article  PubMed  Google Scholar 

  61. Van der Schilden JL. Improvements in rehabilitation of the postmeniscectomized or meniscal-repaired patient. Clin Orthop 1990; 252: 73–9

    Google Scholar 

  62. Schimmer RC, Brülhart KB, Duff C, et al. Fourteen years experience of arthroscopic meniscal surgery: long-term outcome [in German]. Arthroskopie 1993; 6: 228–33

    Google Scholar 

  63. Engel JM. Schmerztherapie der Arthrose. Internist 1994; 35:41–8

    PubMed  CAS  Google Scholar 

  64. Doyle DV, Lanham JG. Routine drug treatment of osteoarthritis. Clin Rheum Dis 1994; 10: 277–91

    Google Scholar 

  65. Ghosh P, Read R, Armstrong S, et al. The effects of intraarticular administration of hyaluronan in a model of early osteoarthritis in sheep. I. Gait analysis and radiological and morphological studies. Semin Arthritis Rheum 1993; 22 Suppl. 1: 18–30

    Article  PubMed  CAS  Google Scholar 

  66. Armstrong S, Read R, Gosh P. The effects of intraarticular hyaluronan on cartilage and subchondral bone changes in an ovine model of osteoarthritis. J Rheumatol 1994; 21: 680–8

    PubMed  CAS  Google Scholar 

  67. Graf J, Neusel E, Schneider E, et al. Intra-articular treatment with hyaluronic acid in osteoarthritis of the knee joint: a controlled trial versus mucopolysaccharide polysulfuric acid ester. Clin Exp Rheumatol 1993; 11: 367–72

    PubMed  CAS  Google Scholar 

  68. Puhl W, Bernau A, Greiling H, et al. Intraartikuläres Na-Hyaluronat bei Gonarthrose: eine multizentrische Doppelblindstudie. Osteoarthritis Cartilage 1993; 1: 233–41

    Article  PubMed  CAS  Google Scholar 

  69. Donnelly S, Huskisson EC. Intra-articular hyaluronic acid in the treatment of osteoarthritis of the knee. Eur J Rheumatol 1995; 1: 1–2

    Google Scholar 

  70. Dean DD, Muniz OE, Rodriguez I, et al. Amelioration of lapine osteoarthritis by treatment with glycosaminoglycan-peptide association complex (Rumalon®). Arthritis Rheum 1991; 34: 304–13

    Article  PubMed  CAS  Google Scholar 

  71. Moskowitz RW, Reese JH, Young RG, et al. The effects of Rumalon®, a glycosaminoglycan peptide complex, in a partial meniscectomy model of osteoarthritis in rabbits. J Rheumatol 1991; 18:205–9

    PubMed  CAS  Google Scholar 

  72. Mannoni A, Altman RD, Muniz OE, et al. The effects of methotrexate on normal and osteoarthritic lapine articular cartilage. J Rheumatol 1993; 20: 849–55

    PubMed  CAS  Google Scholar 

  73. Fisher NM, Pendergast DR, Gresham GE, et al. Muscle rehabilitation: its effect on muscular and functional performance of patients with knee osteoarthritis. Arch Phys Med Rehabil 1991; 72: 367–74

    PubMed  CAS  Google Scholar 

  74. Blair SN, Kohl HW, Gordon NF, et al. How much physical activity is good for health?. Annu Rev Public Health 1992; 13: 99–126

    Article  PubMed  CAS  Google Scholar 

  75. Hurley MV, Newham DJ. The influence of arthrogenous muscle inhibition on quadriceps rehabilitation of patients with early, unilateral osteoarthritic knees. Br J Rheumatol 1993; 32: 127–31

    Article  PubMed  CAS  Google Scholar 

  76. Fisher NM, Gresham GE, Abrams M, et al. Quantitative effects of physical therapy on muscular and functional performance in subjects with osteoarthritis of the knees. Arch Phys Med Rehabil 1993; 74: 840–7

    Article  PubMed  CAS  Google Scholar 

  77. Minor MA. Exercise in the management of osteoarthritis of the knee and hip. Arthritis Care Res 1994; 198-204

  78. Tan J, Balci N, Sepici V, et al. Isokinetic and isometric strength in osteoarthrosis of the knee. Am J Phys Med Rehabil 1995; 74: 364–9

    Article  PubMed  CAS  Google Scholar 

  79. Peterson MGE, Kovar-Toledano PA, Otis JC, et al. Effect of a walking program on gait characteristic in patients with osteoarthritis. Arthritis Care Res 1993; 6: 11–8

    Article  PubMed  CAS  Google Scholar 

  80. Voloshin D, Wesk J. Influence of artificial shock absorbers on human gait. Clin Orthop 1981; 160: 52–6

    PubMed  Google Scholar 

  81. Coventry MB. Osteotomy about the knee for degenerative and rheumatoid arthritis: indications, operative technique, and results. J Bone Joint Surg Am 1973; 55-A: 23–48

    Google Scholar 

  82. Coventry MB. Current concepts review: upper tibial osteotomy for osteoarthritis. J Bone Joint Surg Am 1985; 67-A: 1136–40

    Google Scholar 

  83. Goodfellow JW, O’Connor JJ. Clinical results of the oxford knee: surface arthroplasty of the tibiofemoral joint with a meniscal bearing prosthesis. Clin Orthop 1986; 205: 21–42

    PubMed  Google Scholar 

  84. Freeman MAR. Total knee replacement at the Royal London hospital: 21 years’ experience. In: Aichroth PM, Cannon Jr WD, editors. Knee surgery: current practice. London: Martin Dunitz Ltd, 1992: 641–52

    Google Scholar 

  85. Burks RT. Arthroscopy and degenerative arthritis of the knee: a review of the literature. Arthroscopy 1990; 6: 43–7

    Article  PubMed  CAS  Google Scholar 

  86. Rand JA. Role of arthroscopy in osteoarthritis of the knee. Arthroscopy 1991; 7: 358–63

    Article  PubMed  CAS  Google Scholar 

  87. Glinz W. Arthroskopische Operationstechniken bei degenerativen Meniscus- und Gelenkflächenschäden des Kniegelenks. Chirurg 1993; 64: 371–8

    PubMed  CAS  Google Scholar 

  88. Merchan ECR, Galindo E. Arthroscope-guided surgery versus nonoperative treatment for limited degenerative osteoarthritis of the femorotibial joint in patients over 50 years of age: a prospective comparative study. Arthroscopy 1993; 9: 663–7

    Article  PubMed  CAS  Google Scholar 

  89. Dye SF, McBride JT, Chew M, et al. Unrecognized abnormal osseus metabolic activity in patients with documented meniscal pathology. Am J Sports Med 1989; 17: 723–4

    Google Scholar 

  90. Crues JV, Ryu R, Morgan FW. Meniscal pathology. The expanding role of magnetic resonance imaging. Clin Orthop 1990; 252: 80–7

    PubMed  Google Scholar 

  91. Rangger C, Klestil T, Kathrein A, et al. Influence of magnetic resonance imaging on indication for arthroscopy of the knee. Clin Orthop 1996; 330: 133–42

    Article  PubMed  Google Scholar 

  92. DeHaven KE, Black KP, Griffiths HJ. Open meniscus repair. Am J Sports Med 1989; 17: 788–95

    Article  PubMed  CAS  Google Scholar 

  93. Henning CE, Lynch MA, Yearout KM, et al. Arthroscopic meniscal repair using an exogenous fibrin clot. Clin Orthop 1990; 252: 64–72

    PubMed  Google Scholar 

  94. Arnoczky SP, Warren RF, McDevitt CA. Meniscal replacement using a cryopreserved allograft. An experimental study in dogs. Clin Orthop 1990; 252: 121–8

    PubMed  Google Scholar 

  95. Stone KR, Rodkey WG, Webber RJ, et al. Future directions. Collagen-based prostheses for meniscal regeneration. Clin Orthop 1990; 252: 129–35

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Traumatology, University Hospital of Innsbruck, Innsbruck, Austria

    Christoph Rangger, Anton Kathrein, Thomas Klestil & Wulf Glötzer

Authors
  1. Christoph Rangger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anton Kathrein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas Klestil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wulf Glötzer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rangger, C., Kathrein, A., Klestil, T. et al. Partial Meniscectomy and Osteoarthritis. Sports Med. 23, 61–68 (1997). https://doi.org/10.2165/00007256-199723010-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199723010-00006

Keywords

Search

Navigation