Abstract
BackgroundTo evaluate the risk factor associated with total or subtotal meniscectomy for respective medial and lateral meniscus injury.MethodsThe data of all the meniscus injured patients undergoing arthroscopy in our institute between January 15th, 2000 and December 31st, 2008 was collected and 6034 patients with 7241 injured menisci met the inclusion criteria. The mean patient age was 33.6 ± 14.9 years and there were 4785 males and 2456 females with 3568 medial and 3673 lateral menisci. The decision tree approach was applied to investigate the correlation of the tear type, the duration of complaint, age, gender, ACL rupture and total/subtotal meniscectomy for respective medial and lateral meniscus.ResultsThe tear type was associated with both medial (χ2 = 70.901, P < 0.001) and lateral (χ2 = 268.019, P < 0.001) total/subtotal meniscectomy. The strongest risk of total/subtotal meniscectomy of both medial and lateral meniscus tear was shown for the complex tear followed by the longitudinal, oblique, horizontal and radial tear of the medial meniscus and followed by horizontal, longitudinal, radial and oblique tear of the lateral meniscus. The risk of total/subtotal medial meniscectomy was significantly elevated for the patients with complex tear and the age of ≤40 years old (χ2 = 21.028, P < 0.001) and those with the oblique, horizontal or radial tear accompanied by ACL rupture (χ2 = 6.631, P = 0.01). Besides, the duration of complaint was also associated with total/subtotal meniscectomy of the medial longitudinal tear with ACL rupture (χ2 = 17.155, P < 0.001). On the other side, the risk of total/subtotal lateral meniscectomy was significantly elevated for the complex tear of the female patients (χ2 = 5.877, P = 0.015) with no ACL rupture (χ2 = 50.501, P < 0.001). The ACL rupture was associated with a decreased risk of total/subtotal meniscectomy for all the types of the lateral meniscus (complex: χ2 = 50.501, P < 0.001; horizontal: χ2 = 20.897, P < 0.001; oblique: χ2 = 27.413, P < 0.001; longitudinal and radial: χ2 = 110.85, P < 0.001).ConclusionAnalyzing data from a big sample available in an Asian patient database, we found different risk factors associated with total/subtotal meniscectomy for respective medial and lateral meniscus. Identifying patients at high risk for total/subtotal meniscectomy may allow for interventions after meniscus injury.
Highlights
To evaluate the risk factor associated with total or subtotal meniscectomy for respective medial and lateral meniscus injury
Identifying patients at high risk for total/subtotal meniscectomy may allow for interventions after meniscus injury
The risk of total/subtotal medial meniscectomy was significantly elevated for the complex tear with less than 40 years old (χ2 = 21.028, P < 0.001) and the oblique, horizontal or radial tear accompanied by anterior cruciate ligament (ACL) rupture (χ2 = 6.631, P = 0.01)
Summary
To evaluate the risk factor associated with total or subtotal meniscectomy for respective medial and lateral meniscus injury. Despite of meniscus repair and transplantation, total or subtotal meniscectomy was still inevitable for severe meniscus injury. Identifying patients at high risk for total/subtotal meniscectomy may allow for interventions after meniscus injury. Some risk factors have been confirmed to be associated with meniscus injuries [8, 9], including gender, sport, and type of exposure [5, 10, 11]. A large series of patients undergoing anterior cruciate ligament (ACL) reconstruction identified that increased age, male gender, and increased surgical delay were associated with a higher frequency and severity of meniscus injuries [12]. The correlation between the surgical option (partial or total meniscectomy or repair) and the patients’ parameters has been rarely studied
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