Two-Year Outcomes After Meniscoplasty by Capsular Advancement With the Application of Arthroscopic Centralization Technique for Lateral Compartment Knee Osteoarthritis

Abstract

Background: A high prevalence of osteoarthritis (OA) progression in patients with lateral meniscal defects has been reported. However, optimal management techniques for active patients remain ill-defined. Hypothesis: Meniscoplasty by capsular advancement with the application of the centralization technique would improve clinical and radiological outcomes in patients with lateral compartment OA attributed to lateral meniscal defects. Study Design: Case series; Level of evidence, 4. Methods: A total of 27 patients were enrolled who had undergone meniscoplasty by capsular advancement for lateral compartment OA attributed to lateral meniscal defects. In these patients, the meniscotibial capsule was released from the tibia and advanced with the remaining meniscus onto the rim of the tibial plateau to reform a meniscus-like configuration. Measures of clinical outcomes included clinical examination, Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Knee injury and Osteoarthritis Outcome Score (KOOS), subjective rating scales regarding recovery of the operated knee, and sports performance level. Measures of radiographic outcomes included meniscal extrusion width or regeneration of the meniscus-like tissue on magnetic resonance imaging and lateral joint space width on standing extension anteroposterior and Rosenberg views. All clinical and radiographic outcomes were reported preoperatively and 2 years postoperatively, except magnetic resonance imaging findings, which were reported preoperatively and 1 year postoperatively. Results: The clinical outcomes were significantly improved 2 years postoperatively as compared with baseline: Lysholm score, IKDC subjective score, and KOOS subscores (all P < .0001). The patients’ subjective recovery (P < .0001) and sports performance level (P < .0001) were also improved. One year postoperatively, 10 of 11 patients who had no meniscus remaining at the middle segment showed more than one-third the volume of meniscal tissue–like regeneration, and meniscal extrusion width was significantly reduced as compared with baseline in the remaining 16 patients (P = .0006). Joint space width increased at 2 years on the standing anteroposterior view (P < .0001) and the Rosenberg view (P = .0001). Conclusion: Meniscoplasty of the lateral meniscus by capsular advancement improved clinical and radiographic outcomes at 2-year follow-up in patients with lateral compartment OA attributed to lateral meniscal defects.