Abstract
Purpose
To examine degenerative changes in all cartilage surfaces of the knee following arthroscopic partial medial meniscectomy.
Methods
For this prospective cohort study, 14 patients (five female) with a mean age of 47.9 ± 12.9 years who had undergone isolated arthroscopic partial medial meniscectomy were evaluated. Cartilage-sensitive magnetic resonance imaging (MRI) scans were acquired from the operated knees before the index operations, as well as at 6, 12, and 24 months after surgery. The MRI scans were assessed for the prevalence, severity, and size of cartilage degenerations. The clinical outcome was assessed using the SF-36 physical and mental component score and the International Knee Documentation Committee Knee Evaluation Form and was correlated with radiological findings.
Results
There was a significant increase in the severity of cartilage lesions in the medial tibial plateau (P = 0.019), as well as a trend towards an increase in the lateral tibial plateau. The size of the cartilage lesions increased significantly in the medial femoral condyle (P = 0.005) and lateral femoral condyle (P = 0.029), as well as in the patella (P = 0.019). Functional outcome scores improved significantly throughout the follow-up period. There was no correlation between cartilage wear and functional outcome.
Conclusions
Arthroscopic partial medial meniscectomy is associated with adverse effects on articular cartilage and may lead to an increase in the severity and size of cartilage lesions. Post-operative cartilage wear predominantly affected the medial compartment and also affected the other compartments of the knee. Strategies to reduce subsequent osteoarthritic changes need to involve all compartments of the knee.
Level of evidence
IV.
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References
Aagaard H, Verdonk R (1999) Function of the normal meniscus and consequences of meniscal resection. Scand J Med Sci Sports 9(3):134–140
Amin S, Baker K, Niu J, Clancy M, Goggins J, Guermazi A, Grigoryan M, Hunter DJ, Felson DT (2009) Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis. Arthritis Rheum 60(1):189–198
Baratz ME, Fu FH, Mengato R (1986) Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med 14(4):270–275
Benedetto KP, Rangger C (1993) Arthroscopic partial meniscectomy: 5-year follow-up. Knee Surg Sports Traumatol Arthrosc 1(3–4):235–238
Bolano LE, Grana WA (1993) Isolated arthroscopic partial meniscectomy. Functional radiographic evaluation at five years. Am J Sports Med 21(3):432–437
Burks RT, Metcalf MH, Metcalf RW (1997) Fifteen-year follow-up of arthroscopic partial meniscectomy. Arthroscopy 13(6):673–679
Casula V, Hirvasniemi J, Lehenkari P, Ojala R, Haapea M, Saarakkala S, Lammentausta E, Nieminen MT (2014) Association between quantitative MRI and ICRS arthroscopic grading of articular cartilage. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3286-9
Chatain F, Adeleine P, Chambat P, Neyret P (2003) A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 19(8):842–849
Conaghan PG, Felson D, Gold G, Lohmander S, Totterman S, Altman R (2006) MRI and non-cartilaginous structures in knee osteoarthritis. Osteoarthritis Cartilage 14(Suppl A):A87–A94
Dempsey AR, Wang Y, Thorlund JB, Mills PM, Wrigley TV, Bennell KL, Metcalf BR, Hanna F, Cicuttini FM, Lloyd DG (2013) The relationship between patellofemoral and tibiofemoral morphology and gait biomechanics following arthroscopic partial medial meniscectomy. Knee Surg Sports Traumatol Arthrosc 21(5):1097–1103
Ding C, Garnero P, Cicuttini F, Scott F, Cooley H, Jones G (2005) Knee cartilage defects: association with early radiographic osteoarthritis, decreased cartilage volume, increased joint surface area and type II collagen breakdown. Osteoarthritis Cartilage 13(3):198–205
Domayer SE, Welsch GH, Dorotka R, Mamisch TC, Marlovits S, Szomolanyi P, Trattnig S (2008) MRI monitoring of cartilage repair in the knee: a review. Semin Musculoskelet Radiol 12(4):302–317
Eckstein F, Cicuttini F, Raynauld JP, Waterton JC, Peterfy C (2006) Magnetic resonance imaging (MRI) of articular cartilage in knee osteoarthritis (OA): morphological assessment. Osteoarthritis Cartilage 14(Suppl A):A46–A75
Eckstein F, Hudelmaier M, Wirth W, Kiefer B, Jackson R, Yu J, Eaton CB, Schneider E (2006) Double echo steady state magnetic resonance imaging of knee articular cartilage at 3 Tesla: a pilot study for the Osteoarthritis Initiative. Ann Rheum Dis 65(4):433–441
Elahi S, Cahue S, Felson DT, Engelman L, Sharma L (2000) The association between varus-valgus alignment and patellofemoral osteoarthritis. Arthritis Rheum 43(8):1874–1880
Englund M, Lohmander LS (2004) Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum 50(9):2811–2819
Englund M, Lohmander LS (2005) Patellofemoral osteoarthritis coexistent with tibiofemoral osteoarthritis in a meniscectomy population. Ann Rheum Dis 64(12):1721–1726
Englund M, Roos EM, Roos HP, Lohmander LS (2001) Patient-relevant outcomes fourteen years after meniscectomy: influence of type of meniscal tear and size of resection. Rheumatology (Oxford) 40(6):631–639
Ericsson YB, Roos EM, Dahlberg L (2006) Muscle strength, functional performance, and self-reported outcomes four years after arthroscopic partial meniscectomy in middle-aged patients. Arthritis Rheum 55(6):946–952
Friedrich KM, Reiter G, Kaiser B, Mayerhofer M, Deimling M, Jellus V, Horger W, Trattnig S, Schweitzer M, Salomonowitz E (2011) High-resolution cartilage imaging of the knee at 3T: basic evaluation of modern isotropic 3D MR-sequences. Eur J Radiol 78(3):398–405
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
Hollis JM, Pearsall AW 4th, Niciforos PG (2000) Change in meniscal strain with anterior cruciate ligament injury and after reconstruction. Am J Sports Med 28(5):700–704
Hulet CH, Locker BG, Schiltz D, Texier A, Tallier E, Vielpeau CH (2001) Arthroscopic medial meniscectomy on stable knees. J Bone Joint Surg Br 83(1):29–32
Insall JN, et al. (1984) Surgery of the Knee. In. Churchill Livingstone, New York, Edinburgh, London, and Melbourne
Jeong HJ, Lee SH, Ko CS (2012) Meniscectomy. Knee Surg Relat Res 24(3):129–136
Jones RE, Smith EC, Reisch JS (1978) Effects of medial meniscectomy in patients older than forty years. J Bone Joint Surg Am 60(6):783–786
Katz JN, Meredith DS, Lang P, Creel AH, Yoshioka H, Neumann G, Fossel AH, de Pablo P, Losina E (2006) Associations among preoperative MRI features and functional status following arthroscopic partial meniscectomy. Osteoarthritis Cartilage 14(5):418–422
Lee SJ, Aadalen KJ, Malaviya P, Lorenz EP, Hayden JK, Farr J, Kang RW, Cole BJ (2006) Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 34(8):1334–1344
McCarty EC, Marx RG, DeHaven KE (2002) Meniscus repair: considerations in treatment and update of clinical results. Clin Orthop Relat Res 402:122–134
Messner K, Gao J (1998) The menisci of the knee joint. Anatomical and functional characteristics, and a rationale for clinical treatment. J Anat 193:161–178
Mills PM, Wang Y, Cicuttini FM, Stoffel K, Stachowiak GW, Podsiadlo P, Lloyd DG (2008) Tibio-femoral cartilage defects 3–5 years following arthroscopic partial medial meniscectomy. Osteoarthritis Cartilage 16(12):1526–1531
Petersen MM, Olsen C, Lauritzen JB, Lund B, Hede A (1996) Late changes in bone mineral density of the proximal tibia following total or partial medial meniscectomy. A randomized study. J Orthop Res 14(1):16–21
Rangger C, Klestil T, Gloetzer W, Kemmler G, Benedetto KP (1995) Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 23(2):240–244
Roos H, Lauren M, Adalberth T, Roos EM, Jonsson K, Lohmander LS (1998) Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis Rheum 41(4):687–693
Salata MJ, Gibbs AE, Sekiya JK (2010) A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med 38(9):1907–1916
Sandy JD (2003) Proteolytic degradation of normal and osteoarthritic cartilage matrix. In: Brandt KD, Doherty M, Lohmander LS (eds) Osteoarthritis, 2nd edn. Oxford University Press, Oxford, pp 82–92
Schimmer RC, Brulhart KB, Duff C, Glinz W (1998) Arthroscopic partial meniscectomy: a 12-year follow-up and two-step evaluation of the long-term course. Arthroscopy 14(2):136–142
Souza RB, Wu SJ, Morse LJ, Subburaj K, Allen CR, Feeley BT (2015) Cartilage MRI relaxation times after arthroscopic partial medial meniscectomy reveal localized degeneration. Knee Surg Sports Traumatol Arthrosc 23(1):188–197
Sturnieks DL, Besier TF, Hamer PW, Ackland TR, Mills PM, Stachowiak GW, Podsiadlo P, Lloyd DG (2008) Knee strength and knee adduction moments following arthroscopic partial meniscectomy. Med Sci Sports Exerc 40(6):991–997
Wang Y, Dempsey AR, Lloyd DG, Mills PM, Wrigley T, Bennell KL, Metcalf B, Hanna F, Cicuttini FM (2012) Patellofemoral and tibiofemoral articular cartilage and subchondral bone health following arthroscopic partial medial meniscectomy. Knee Surg Sports Traumatol Arthrosc 20(5):970–978
Welsch GH, Mamisch TC, Hughes T, Domayer S, Marlovits S, Trattnig S (2008) Advanced morphological and biochemical magnetic resonance imaging of cartilage repair procedures in the knee joint at 3 Tesla. Semin Musculoskelet Radiol 12(3):196–211
Williams RJ 3rd, Warner KK, Petrigliano FA, Potter HG, Hatch J, Cordasco FA (2007) MRI evaluation of isolated arthroscopic partial meniscectomy patients at a minimum five-year follow-up. HSS J 3(1):35–43
Yoon KH, Lee SH, Bae DK, Park SY, Oh H (2013) Does varus alignment increase after medial meniscectomy? Knee Surg Sports Traumatol Arthrosc 21(9):2131–2136
Zeichen J, Hankemeier S, Knobloch K, Jagodzinski M (2006) Die arthroskopische Meniskusteilresektion. Oper Orthop Traumatol 18(5–6):380–392
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Eichinger, M., Schocke, M., Hoser, C. et al. Changes in articular cartilage following arthroscopic partial medial meniscectomy. Knee Surg Sports Traumatol Arthrosc 24, 1440–1447 (2016). https://doi.org/10.1007/s00167-015-3542-7
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DOI: https://doi.org/10.1007/s00167-015-3542-7