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Long-term results of meniscus repair and meniscectomy: A 13-year functional and radiographic follow-up study
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Faculty of Health Sciences.
2000 (English)In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 8, no 1, 2-9 p.Article in journal (Refereed) Published
Abstract [en]

This study investigated the long-term outcome of common meniscus treatment (meniscectomy, repair). A consecutive series of 30 patients with open meniscus repair were compared retrospectively to 30 patients who had an arthroscopic partial or subtotal meniscectomy. The groups were matched according to sex, age, meniscus lesion, and follow-up time. The patients were aged 13-43 years at the time of operation, all had intact cruciate ligaments, and none had had previous surgery on the knee. Patients were reexamined at a mean of 13 years after the operation. In addition, for a subgroup of 22 matched pairs, data were available from a 7-year follow-up. Four of the repaired menisci did not heal, and another three reruptured during the 13-year follow-up, these menisci were all excised (23%). Meniscal remnant surgery was needed in 6 cases (20%) after initial meniscectomy. At the 13-year follow-up there was no difference between the groups in knee function, subjective complaints, or manual findings. Almost 90% of the patients in both groups had no knee problems during daily activities. At the late follow-up radiographic signs for bone spurs, sclerosis, or flattening of the femoral condyle were found in around half of the cases in each group. Three patients (10%) with initial repair and 8 (27%) with meniscectomy had minor joint space reduction, but no patient had more severe radiographic changes. After 7 years (subgroup) joint space reduction was more common after initial meniscectomy than after repair (P < 0.05). After 13 years the incidence and severity of arthrosis did not differ significantly between the two groups, even when only the successful repairs were compared to meniscectomy (P = 0.06).

Place, publisher, year, edition, pages
2000. Vol. 8, no 1, 2-9 p.
Keyword [en]
Meniscus treatment, Long-term results, Knee function, Radiographic osteoarthrosis
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-27891DOI: 10.1007/s001670050002Local ID: 12651OAI: diva2:248443
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-08-03Bibliographically approved
In thesis
1. Clinical and radiographic outcome of meniscectomy and meniscus repair in the stable knee
Open this publication in new window or tab >>Clinical and radiographic outcome of meniscectomy and meniscus repair in the stable knee
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Increasing knowledge about the function of the meniscus and arthroscopy have made meniscus surgery more conservative. Arthroscopy was developed during the 70's and enabled the surgeon to select the most appropriate and tissue conserving therapy for a meniscus lesion. Arthroscopic meniscectomy and meniscus repair were introduced as new techniques for treatment of meniscus lesions.

This thesis comprises five long term follow-up studies of arthroscopic meniscectomy and open meniscus repair and one short term follow-up study of arthroscopic meniscectomy.

The long term follow-up studies include 152 patients, 113 with meniscectomy and 39 with meniscus repair, with stable knees, age less than 44 years and without preexisting gonarthrosis. All patients had a diagnostic at1hroscopy at the index operation and were evaluated clinically and radiographically 13-14 years after surgery.

At follow-up the frequency of radiographic changes was high but in general the radiographic changes were of a low grade. Only seven patients, 4 of 86 (5%) after partial meniscectomy and 3 of 27. (11%) after total meniscectomy fulfilled the criteria for gonarthrosis (minimal joint space less than 3 mm on radiographs and symptoms). More radiographic changes were found after total meniscectomy than after partial meniscectomy, meniscus repair or than in an un-injured control group. A similar rate of radiographic changes was seen when meniscus repair was compared to matched patients with partial and total meniscectomy. Knee function was in general good at follow-up and did not differ between patients with total meniscectomy and partial meniscectomy but patients with meniscus repair had a somewhat better knee function than a group of patients with partial and total meniscectomy. Cartilage fibril1ation present at meniscectomy did not influence the frequency of radiographic changes, knee function or activity at follow-up but older patients had more radiographic changes after meniscectomy than younger patients. The activity level decreased in a similar fashion over time after total meniscectomy, partial meniscectomy, meniscus repair and in un-injured subjects indicating that factors other than the knee injury and meniscus operation determines the decline in activity.

Thus, irrespective of meniscus treatment (arthroscopic partial/total meniscectomy and meniscus repair), in a 13-14 year perspective, the grade of radiographic changes in the knee joint were relatively low with no influence on activity and little influence on knee function.

In the short term follow-up study original data from patients with arthroscopic meniscectomy in the early 80' s when the technique was new was compared to similar data from patients operated today, when the technique is in routine use. The operation time was shorter and the frequency of subtotal meniscectomy was less today. In contrast to the early 80's the procedure is entirely out-patient. However, recovery and in particular return to sports were delayed today in comparison to previously.

A less supervised rehabilitation is suggested to be the main cause to the delayed recovery and a generosity with supervised rehabilitation after arthroscopic meniscectomy is advisable.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 60 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 616
Arthroscopy, Meniscectomy, Meniscus Repair, Follow-up, Arthrosis
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-28071 (URN)12835 (Local ID)91-7219-573-8 (ISBN)12835 (Archive number)12835 (OAI)
Public defence
2000-02-18, Sal K3, Kåkenhus, Bredgatan 33, Campus Norrköping, Norrköping, 09:00 (Swedish)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-11-09Bibliographically approved

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Rockborn, PeterMessner, Karola
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