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Arthroscopic Partial and Total Meniscectomy: A Long-term Follow-up Study With Matched Controls
Department of Radiology, Vrinnevi Hospital, Norrköping, Sweden.
Department of Radiology, Vrinnevi Hospital, Norrköping, Sweden.
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Faculty of Health Sciences.
2002 (English)In: Arthroscopy: The Journal of Arthroscopy And Related, ISSN 0749-8063, E-ISSN 1526-3231, Vol. 18, no 2, 183-189 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this study was to compare the clinical and radiographic outcome of arthroscopic partial and total meniscectomy.

Type of Study: Retrospective outcome study.

Methods: Thirty-six male patients with stable knees, no previous knee injury, and arthroscopic meniscectomy were matched into 2 groups: partial or total. In addition, a group of individuals with no known history of knee injury was matched to each patient with meniscectomy. All patients were re-examined by a clinical and radiographic examination 14 years after surgery.

Results: At follow-up, radiographic changes, including Fairbank changes and joint space narrowing, were seen in 6 of 18 patients (33%) after partial meniscectomy and in 13 of 18 patients (72%) after total meniscectomy (P < .05). Joint space narrowing >50% of the joint space was seen in 1 patient after partial meniscectomy but was present in 7 patients after total meniscectomy. In the healthy controls, 4 of 36 patients (11%) had radiographic changes but none had joint space narrowing. Fourteen years after surgery almost 70% of patients had a Lysholm score >94 (i.e., normal). Only 5 of 36 patients (14%) in the total meniscectomy group had knee symptoms during activities of daily living. A similar decline in activity levels according to Tegner was seen over time in the control group and in the 2 meniscectomy groups. Conclusions: The frequency of radiographic changes 14 years after meniscectomy is related to the size of the meniscus removed, but the grades of these changes are low and have little influence on activity and knee function.

Place, publisher, year, edition, pages
2002. Vol. 18, no 2, 183-189 p.
Keyword [en]
Arthroscopy, Arthrosis, Follow-up, Meniscectomy
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-47113DOI: 10.1053/jars.2002.30435OAI: diva2:268009
Swedish Research Council, 10396
Available from: 2009-10-11 Created: 2009-10-11 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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