Unfavorable Results of Partial Meniscectomy for Complete Posterior Medial Meniscus Root Tear With Early Osteoarthritis: A 5- to 8-Year Follow-Up Study

Purpose The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of arthroscopic partial meniscectomy for complete posterior medial meniscus root tear (PMMRT) in patients with early radiographic evidence of knee osteoarthritis at a minimum follow-up of 5 years. Meth...

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Veröffentlicht in:Arthroscopy 2010-10, Vol.26 (10), p.1326-1332
Hauptverfasser: Han, Seung Beom, M.D, Shetty, Gautam M., M.S.Orth, Lee, Dae Hee, M.D, Chae, Dong Ju, M.D, Seo, Seung Suk, M.D, Wang, Kook Hyun, M.D, Yoo, Si Hoon, M.D, Nha, Kyung Wook, M.D
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container_end_page 1332
container_issue 10
container_start_page 1326
container_title Arthroscopy
container_volume 26
creator Han, Seung Beom, M.D
Shetty, Gautam M., M.S.Orth
Lee, Dae Hee, M.D
Chae, Dong Ju, M.D
Seo, Seung Suk, M.D
Wang, Kook Hyun, M.D
Yoo, Si Hoon, M.D
Nha, Kyung Wook, M.D
description Purpose The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of arthroscopic partial meniscectomy for complete posterior medial meniscus root tear (PMMRT) in patients with early radiographic evidence of knee osteoarthritis at a minimum follow-up of 5 years. Methods Forty-six cases had complete PMMRT with follow-up of at least 5 years and were treated with arthroscopic partial meniscectomy. On the basis of medical records, we reviewed the arthroscopic findings of joint degeneration (Outerbridge grading), clinical results using the modified Lysholm (ML) knee score and a patient questionnaire, and radiographic evaluation of degeneration using Kellgren-Lawrence (KL) grading. Results The incidence of complete PMMRT in the study population was 15%. At a mean follow-up of 78 months (range, 60 to 103 months), the mean ML score significantly improved from 72 (range, 62 to 78) preoperatively to 77 (range, 70 to 98) at final follow-up ( P < .01), 16 patients (35%) showed progression of degeneration from KL grade 0 to 2 preoperatively to KL grade 2 to 4, 56% of patients indicated improvement in pain, 67% of patients were satisfied with the results of the procedure, and 19% of patients underwent reoperation. There was a significant negative correlation between chondral wear during arthroscopy (ρ = −0.516, P = .002) and preoperative KL grade (ρ = −0.429, P = .004) with ML score at final follow-up. Conclusions Although arthroscopic partial meniscectomy for complete PMMRT significantly improved ML scores postoperatively, only 56% of patients had improvement in pain, 67% were satisfied with the outcome of the procedure, and 35% showed radiographic progression of osteoarthritis at a mean follow-up of 77 months. Level of Evidence Level IV, therapeutic study.
doi_str_mv 10.1016/j.arthro.2010.01.032
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Methods Forty-six cases had complete PMMRT with follow-up of at least 5 years and were treated with arthroscopic partial meniscectomy. On the basis of medical records, we reviewed the arthroscopic findings of joint degeneration (Outerbridge grading), clinical results using the modified Lysholm (ML) knee score and a patient questionnaire, and radiographic evaluation of degeneration using Kellgren-Lawrence (KL) grading. Results The incidence of complete PMMRT in the study population was 15%. At a mean follow-up of 78 months (range, 60 to 103 months), the mean ML score significantly improved from 72 (range, 62 to 78) preoperatively to 77 (range, 70 to 98) at final follow-up ( P &lt; .01), 16 patients (35%) showed progression of degeneration from KL grade 0 to 2 preoperatively to KL grade 2 to 4, 56% of patients indicated improvement in pain, 67% of patients were satisfied with the results of the procedure, and 19% of patients underwent reoperation. There was a significant negative correlation between chondral wear during arthroscopy (ρ = −0.516, P = .002) and preoperative KL grade (ρ = −0.429, P = .004) with ML score at final follow-up. Conclusions Although arthroscopic partial meniscectomy for complete PMMRT significantly improved ML scores postoperatively, only 56% of patients had improvement in pain, 67% were satisfied with the outcome of the procedure, and 35% showed radiographic progression of osteoarthritis at a mean follow-up of 77 months. Level of Evidence Level IV, therapeutic study.</description><identifier>ISSN: 0749-8063</identifier><identifier>EISSN: 1526-3231</identifier><identifier>DOI: 10.1016/j.arthro.2010.01.032</identifier><identifier>PMID: 20887931</identifier><identifier>CODEN: ARTHE3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Arthroscopy ; Biological and medical sciences ; Cartilage, Articular - anatomy &amp; histology ; Cartilage, Articular - injuries ; Diseases of the osteoarticular system ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Menisci, Tibial - surgery ; Middle Aged ; Orthopedic surgery ; Orthopedics ; Osteoarthritis ; Osteoarthritis - complications ; Osteoarthritis - surgery ; Patient Satisfaction ; Reoperation - statistics &amp; numerical data ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surveys and Questionnaires ; Tibial Meniscus Injuries ; Time Factors ; Treatment Failure</subject><ispartof>Arthroscopy, 2010-10, Vol.26 (10), p.1326-1332</ispartof><rights>2010</rights><rights>2015 INIST-CNRS</rights><rights>Crown Copyright © 2010. Published by Elsevier Inc. 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Methods Forty-six cases had complete PMMRT with follow-up of at least 5 years and were treated with arthroscopic partial meniscectomy. On the basis of medical records, we reviewed the arthroscopic findings of joint degeneration (Outerbridge grading), clinical results using the modified Lysholm (ML) knee score and a patient questionnaire, and radiographic evaluation of degeneration using Kellgren-Lawrence (KL) grading. Results The incidence of complete PMMRT in the study population was 15%. At a mean follow-up of 78 months (range, 60 to 103 months), the mean ML score significantly improved from 72 (range, 62 to 78) preoperatively to 77 (range, 70 to 98) at final follow-up ( P &lt; .01), 16 patients (35%) showed progression of degeneration from KL grade 0 to 2 preoperatively to KL grade 2 to 4, 56% of patients indicated improvement in pain, 67% of patients were satisfied with the results of the procedure, and 19% of patients underwent reoperation. There was a significant negative correlation between chondral wear during arthroscopy (ρ = −0.516, P = .002) and preoperative KL grade (ρ = −0.429, P = .004) with ML score at final follow-up. Conclusions Although arthroscopic partial meniscectomy for complete PMMRT significantly improved ML scores postoperatively, only 56% of patients had improvement in pain, 67% were satisfied with the outcome of the procedure, and 35% showed radiographic progression of osteoarthritis at a mean follow-up of 77 months. 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Methods Forty-six cases had complete PMMRT with follow-up of at least 5 years and were treated with arthroscopic partial meniscectomy. On the basis of medical records, we reviewed the arthroscopic findings of joint degeneration (Outerbridge grading), clinical results using the modified Lysholm (ML) knee score and a patient questionnaire, and radiographic evaluation of degeneration using Kellgren-Lawrence (KL) grading. Results The incidence of complete PMMRT in the study population was 15%. At a mean follow-up of 78 months (range, 60 to 103 months), the mean ML score significantly improved from 72 (range, 62 to 78) preoperatively to 77 (range, 70 to 98) at final follow-up ( P &lt; .01), 16 patients (35%) showed progression of degeneration from KL grade 0 to 2 preoperatively to KL grade 2 to 4, 56% of patients indicated improvement in pain, 67% of patients were satisfied with the results of the procedure, and 19% of patients underwent reoperation. There was a significant negative correlation between chondral wear during arthroscopy (ρ = −0.516, P = .002) and preoperative KL grade (ρ = −0.429, P = .004) with ML score at final follow-up. Conclusions Although arthroscopic partial meniscectomy for complete PMMRT significantly improved ML scores postoperatively, only 56% of patients had improvement in pain, 67% were satisfied with the outcome of the procedure, and 35% showed radiographic progression of osteoarthritis at a mean follow-up of 77 months. Level of Evidence Level IV, therapeutic study.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20887931</pmid><doi>10.1016/j.arthro.2010.01.032</doi><tpages>7</tpages></addata></record>
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subjects Arthroscopy
Biological and medical sciences
Cartilage, Articular - anatomy & histology
Cartilage, Articular - injuries
Diseases of the osteoarticular system
Endoscopy
Female
Follow-Up Studies
Humans
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Imaging - methods
Male
Medical sciences
Menisci, Tibial - surgery
Middle Aged
Orthopedic surgery
Orthopedics
Osteoarthritis
Osteoarthritis - complications
Osteoarthritis - surgery
Patient Satisfaction
Reoperation - statistics & numerical data
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surveys and Questionnaires
Tibial Meniscus Injuries
Time Factors
Treatment Failure
title Unfavorable Results of Partial Meniscectomy for Complete Posterior Medial Meniscus Root Tear With Early Osteoarthritis: A 5- to 8-Year Follow-Up Study
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