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Short term outcome of arthroscopic meniscectomy in stable knees 1980 and 1995
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Faculty of Health Sciences.
Department of Orthopedic Surgery, South Hospital, Stockholm.
Linköping University, Department of Medical and Health Sciences, Sports Medicine . Linköping University, Faculty of Health Sciences.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Original data from 86 consecutive patients with arthroscopic meniscectomy 1980-81 was compared to similar data from 82 consecutive patients operated on 1995-1998. All knees were stable and without severe cartilage changes. In 1980 a follow-up examination was performed 10 (6-17) months after surgery and 1995 the patients answered two questionnaires 3 and/or more than 12 months after surgery. Age, sex and activity level before injury did not differ between the series and the distribution of meniscus tear types was similar.

In 1995 all patients were treated as outpatients while one third of the patients remained in hospital for 1-3 days in 1980. The operating time was shorter and the frequency of subtotal meniscectomy was less in 1995. Sick leave did not differ between the series and 2 out of 3 patients were back at work within one week. In 1995 almost half of the patients still had some knee problems 3 months after surgery but thereafter a substantial improvement was seen. The time to recovery was longer 1995 than in 1980. At the final follow-up the activity level and frequency of complete recovery did not differ between the series.

We conclude that the improved technique for arthroscopic meniscectomy during the last 15 to 20 years and less supervised rehabilitation has decreased the costs and freed resources for other patients. However, with the simplified rehabilitation, the previous opinion of a very fast recovery after arthroscopic meniscectomy has to be reevaluated.

National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-79487OAI: oai:DiVA.org:liu-79487DiVA: diva2:542863
Available from: 2012-08-03 Created: 2012-08-03 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.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 616
Keyword
Arthroscopy, Meniscectomy, Meniscus Repair, Follow-up, Arthrosis
National Category
Medical and Health Sciences
Identifiers
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)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-11-09Bibliographically approved

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Rockborn, PeterGillquist, Jan

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