Arthroscopic Partial Lateral Meniscectomy Research Articles

Clinical and radiographic results of arthroscopic partial lateral meniscectomies in stable knees with a minimum follow up of 20 years.

The purpose of this retrospective multicentric study was to evaluate the long-term effects of lateral meniscectomy and to identify those patients who are at the most risk of developing osteoarthritis (OA). Eighty-nine arthroscopic partial lateral meniscectomies in stable knees with a mean follow-up of 22 ± 3 years were included. The following influencing factors were analyzed: age, sex, body mass index (BMI), physical activity, alignment, the types of meniscal lesions, the extent of meniscal resections and the initially associated cartilage lesions. An independent examiner reviewed all patients, using subjective (KOOS and IKDC scores) and objective clinical and radiological evaluations (IKDC score). The contralateral knee was used as a reference to calculate the prevalence and the incidence of OA. The mean age at the time of surgery was 35 ± 13 years. The main location of the lesions was the mid-section of the lateral meniscus (79% of the cases). At the latest follow-up, 48% of the patients had an active lifestyle with as many as 48% of the patients enjoying moderate to intense physical activity 22 years after the procedure (vs. 71% before surgery). The KOOS score evolved from 82 to 69% during the same period. The prevalence of OA was 56% in the affected knee and the difference of prevalence between the operated and healthy knees was 44%. In those patients presenting with an OA of the operated knee and a normal contralateral knee, the incidence of OA was 53%. Predictors of OA were an age superior to 38 years at the time of surgery, obesity (BMI >30), and valgus malalignment as well as the presence of cartilage and degenerative meniscal lesions at the time of surgery. In the long term, arthroscopic partial lateral meniscectomy in stable knees without initial cartilage lesions might yield good to excellent results in young patients. Patients are at higher risk to develop symptomatic OA if they are over 40, having a high BMI, valgus malalignment and cartilage lesions at the time of surgery. This study provides precise guidelines for the surgical treatment of lateral meniscus tears. IV.

Return to Play After Partial Lateral Meniscectomy in National Football League Athletes

Background: Lateral meniscal injury is a common and possibly career-threatening injury among players in the National Football League (NFL). The rate of return to play (RTP) and factors that affect RTP after lateral meniscal injury in NFL players are currently not defined. Purpose: The aims of this study were to determine the rate of RTP to regular-season NFL game play of NFL players after arthroscopic partial lateral meniscectomy and to identify factors that can predict the ability to return to play. Study Design: Case series; Level of evidence, 4. Methods: Seventy-two patients undergoing 77 arthroscopic lateral partial meniscectomies were followed to determine the rate of RTP (defined as successful RTP in at least 1 regular-season NFL game after meniscectomy) and factors predicting players’ ability to return to play. Perioperative variables were recorded using retrospective chart review. Players’ heights and weights, dates of return, draft rounds, and counts of games, starts, and seasons both before and after meniscectomy were all collected from statistical databases maintained by the NFL. Chi-square and Student t tests were performed to assess differences among covariates with respect to an athlete’s ability to return to play, and odds ratios were calculated as appropriate. All percentages were calculated as percent of total procedures performed (n = 77). Results: Of the 77 partial lateral meniscectomies performed, 61% (n = 47) resulted in the athlete returning to play at his previous level of competition with an average length of time to RTP of 8.5 months; 19 (40%) of those who returned were still active in the NFL at the time of follow-up. Age at time of surgery, games and seasons played before surgery, and individual position were not significantly different between those who did and did not return to play. Undergoing a concomitant procedure did not affect an athlete’s ability to return to play, nor did concurrent arthroscopic anterior cruciate ligament reconstruction affect a player’s likelihood to return to play. Players drafted in the first 4 rounds of the NFL draft were 3.7 times more likely to return to play than players drafted after the fourth round, and players who started more than 46.2% of their games played (the mean value for this population) were 2.8 times more likely to return to play. Speed-position players (running backs, receivers, linebackers, and defensive backs) were 4.0 times less likely to return to play than non–speed position players (linemen and tight ends). Conclusion: The majority of NFL players undergoing arthroscopic lateral meniscectomy are able to return to play. Players selected earlier in the NFL draft and who are listed as starters in more of their games are more likely to return to play, as are linemen and tight ends. It is significantly more difficult for running backs, receivers, linebackers, and defensive backs to return to play.

Expression of β-defensin-4 in “an in vivo and ex vivo model” of human osteoarthritic knee meniscus

To investigate, for the first time, the expression of β-defensins-4, by immunohistochemistry and western blotting, in OA meniscus versus control meniscus, thus providing new insights into the physiological processes of meniscus repairing. β-defensins-4 was studied in vivo, in knee osteoarthritic menisci obtained from 30 patients (20 men and 10 women) who underwent isolated arthroscopic partial medial or lateral meniscectomy, and in vitro on fibrochondrocyte cells from human OA knee menisci. The study was conducted using morphological, immunohistochemical, and Western blot analysis. The histological results demonstrated structural alterations and cracks of OA menisci accompanied by a very strong β-defensin-4 immunohistochemical staining. The Western blot analysis confirmed also a strong expression of β-defensin-4 in OA fibrochondrocyte cells. The present study suggests an activation of β-defensin-4 induction, in human knee meniscus induced by the OA inflammatory process. It may represent an endogenous antibiotic defense mechanism accompanied by an intrinsic effort of tissue remodeling in OA articular joints. In conclusion, the present paper suggests the clinical relevance of β-defensin-4 in the prospective of future alternative medical treatment for OA.

MRI Evaluation of Isolated Arthroscopic Partial Meniscectomy Patients at a Minimum Five-Year Follow-up

The risk of radiographic knee degeneration after partial or total meniscectomy is well documented, but no prior study has employed cartilage-sensitive MRI technology to assess degenerative changes after meniscectomy. Arthroscopic partial meniscectomy results in early articular cartilage wear and subchondral bony degeneration, even in the absence of clinical symptoms, and these findings can be evaluated with cartilage-sensitive MRI. Retrospective cohort. Twenty-nine patients (ages: 15-40) who had undergone isolated arthroscopic partial medial or lateral meniscectomy with at least 5-year follow-up were evaluated. All patients had arthroscopically normal articular cartilage at the time of initial meniscectomy. Seventeen patients (18 knees) underwent partial medial meniscectomy (MM) and 12 patients underwent partial lateral meniscectomy (LM) with mean follow-up of 8.4 and 7.1 years, respectively. Follow-up evaluation included physical examination, outcome questionnaires, and cartilage-sensitive MRI examination with modified Outerbridge grading of articular surfaces. Outerbridge grades II-IV were noted in 64% of medial compartment joint surfaces in group MM knees versus 33% of lateral compartment joint surfaces in group LM knees. Abnormal cartilage surfaces (grades II-IV), subchondral sclerosis, and condylar squaring were all significantly more frequent after medial meniscectomy (p < 0.05). Groups MM and LM had no significant differences among outcome scores, which remained excellent in both groups. A significant negative correlation was found between the severity of cartilage wear and functional scoring in the MM group, suggesting that functional disability lags behind early MRI evidence of degeneration. Despite optimal preoperative prognostic factors and excellent functional outcomes, MRI evidence of early articular cartilage degeneration was present in both partial medial and lateral meniscectomy patients at a minimum 5-year follow-up. Results support the use of cartilage-sensitive MRI as a noninvasive screening technique to evaluate cartilage changes after arthroscopic partial meniscectomy and may help to counsel the high-risk patient in regard to postoperative activity.

Rapid chondrolysis after arthroscopic partial lateral meniscectomy in athletes: a case report

We present a patient with a severe chondrolysis after arthroscopic partial lateral meniscectomy in a 17-year-old high school basketball player. This is a rare but severe complication after arthroscopic partial lateral meniscectomy. At 7 months after the first operation, a second-look arthroscopy showed numerous cartilaginous debris floating in the knee and a high-grade cartilage damage on the lateral compartment of the tibia. This unexpected complication and a consideration of its etiology are shown.

Arthroscopic treatment of 105 lateral meniscal cysts with 5-year average follow-up.

To evaluate meniscal damage and the midterm clinical outcome, we performed a retrospective review of 105 lateral meniscal cysts that were treated arthroscopically at our institution. Retrospective review. From a series of 8,100 knee arthroscopies, 122 patients (1.5%) with 124 lateral meniscal cysts were selected. Eight of the patients were lost to follow-up and 11 patients had associated pathology; therefore, 105 lateral meniscal cysts on stable knees were included in this study. Average follow-up was 5 years (range, 1 to 12.5 years). The mean age was 33 years (range, 12 to 69 years). All patients had presented with tenderness over the joint line with a palpable mass. All cases were treated arthroscopically and all patients underwent a complete physical examination before surgery and at last follow-up. Radiographic evaluation was available at final follow-up for 68 cases. All patients had a meniscal tear at the time of surgery and 60 (57%) had a horizontal cleavage component. For meniscal tears, arthroscopic partial lateral meniscectomy was performed in 104 cases and meniscal repair in 1 case. For cysts, intra-articular debridement was performed in 91 cases and open cystectomy in 14. Eleven cysts recurred and a second arthroscopy was required. The clinical results, including those cases with recurrent cysts, were excellent or good in 87% of cases. Osteoarthritis following treatment for meniscal cysts occurred in 9% of cases. When there was a cyst and no other intra-articular damage, the prognosis was excellent. For lateral meniscal cysts, arthroscopic partial meniscectomy with intra-articular debridement yields predictable results. Level IV.

Arthroscopic partial lateral meniscectomy in an otherwise normal knee: Clinical, functional, and radiographic results of a long-term follow-up study

Purpose: To determine the clinical, functional, and radiographic long-term results of patients who underwent arthroscopic partial lateral meniscectomy in an otherwise normal knee. Type of Study: This was a retrospective case-control study. Methods: Between 1982 and 1991, 107 arthroscopic partial lateral meniscectomies were performed; 75 of these patients had an isolated lateral meniscal tear and their data were evaluated using the Lysholm score and a questionnaire recording patients’ subjective satisfaction. Radiographic analysis was performed according to the Jäger-Wirth classification and Fairbank changes. Results: All 75 patients were examined by questionnaire, 55 underwent physical examination, and 58 had radiographic analysis. The follow-up period ranged from 5 to 15 years. Excellent and good Lysholm score results decreased from 77% at maximal improvement to 66% at follow-up; 43% of patients maintained their level of maximal improvement, 78% showed one or more Fairbank changes at follow-up, and using the Jäger-Wirth score, 84% showed radiographic deterioration. Conclusions: Although deterioration of functional and especially radiographic results occurred after arthroscopic partial lateral meniscectomy, the number of good results, even with mean follow-up of 12.3 years, is remarkable. There was a high percentage of radiographic changes in our study, but there is no significant correlation between them and subjective symptoms or between them and functional outcome. We believe that careful meniscectomy provides good results for a long period of time but, the longer the follow-up, the more radiographic changes have to be expected; when meniscal refixation is possible, it should be performed.Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 9 (November-December), 2001: pp 946–952

Long-term results of arthroscopic partial lateral meniscectomy in knees without associated damage

We evaluated the outcome of partial lateral meniscectomy of 31 knees in 29 patients whose knees were otherwise normal. The mean follow-up was 10.3 years. According to the Lysholm score, 14 knees were rated as excellent, four as good, five as fair and eight as poor, with a mean score of 80.5 points. Radiologically, only one lateral compartment was classified as grade 0, eight as grade 1, nine as grade 2, 11 as grade 3, and two as grade 4 according to Tapper and Hoover. No significant (p &lt; 0.05) correlation was found between the amount of tissue resected and the subjective, clinical and radiological outcome. Although early results of lateral meniscectomy may be satisfactory, we have demonstrated that in the long term there was a high incidence of degenerative changes, a high rate of reoperation (29%) and a relatively low functional outcome score.

Long-term results of arthroscopic partial lateral meniscectomy in knees without associated damage.

We evaluated the outcome of partial lateral meniscectomy of 31 knees in 29 patients whose knees were otherwise normal. The mean follow-up was 10.3 years. According to the Lysholm score, 14 knees were rated as excellent, four as good, five as fair and eight as poor, with a mean score of 80.5 points. Radiologically, only one lateral compartment was classified as grade 0, eight as grade 1, nine as grade 2, 11 as grade 3, and two as grade 4 according to Tapper and Hoover. No significant (p < 0.05) correlation was found between the amount of tissue resected and the subjective, clinical and radiological outcome. Although early results of lateral meniscectomy may be satisfactory, we have demonstrated that in the long term there was a high incidence of degenerative changes, a high rate of reoperation (29%) and a relatively low functional outcome score.

Traitement arthroscopique des kystes du ménisque latéral

A retrospective study was performed on 122 patients with 124 lateral meniscal cysts. These were selected from a original pool of 8100 knee arthroscopies (1.5%). Eight of the patients were lost to followup, 11 patients had chronic anterior cruciate ligament deficiency or previous medial meniscectomy, therefore 105 of 124 cases were included in this study. A physical examination was performed on each knee emphasizing, motion, pain, swelling, and ligament evaluation. Radigraphs were graded for degenerative changes for each knee. Average follow-up was 5 years (range of 1 to 12.5 years). The mean age was 33 years (range of 12 to 69 years). All patients had presented tenderness over the joint line with a palpable mass. All were noted to have a meniscal tear at the time of surgery and 60 (57%) had a horizontal cleavage component. All cases were managed by arthroscopy. Meniscal tears were treated by arthroscopic partial lateral meniscectomy in 104 cases and meniscal repair in one case. Cysts were treated by intra-articular debridement in 91 cases and open cystectomy in 14 cases. Eleven cysts recurred and a second arthroscopy was required. The clinical results, including those cases with recurrent cysts, were excellent or good in 87% of cases and in the 13% remaining cases, the results were fair or poor. Osteoarthritis following treatment for meniscal cysts occurred in 9% of cases. When there was a cyst and no other intra-articular damage, the resultss were excellent. For lateral meniscal cysts, arthroscopic partial meniscectomy with intra-articular debridement alone or associated with open cystectomy yields predictable results.

Acute meniscal injury following successful unicompartmental knee arthroplasty

The case of an active 53-year-old man with a well-functioning unicompartmental knee arthroplasty who suffered an acute athletic injury to the knee is described. A mechanical problem was diagnosed and he was successfully treated by arthroscopic partial lateral meniscectomy for a displaced meniscal tear. This case points to an important difference noted by history and physical examination between an acute injury to the unreplaced compartment of a knee with a unicompartmental knee arthroplasty and progression of the arthritic process.

The effects of arthroscopic partial lateral meniscectomy in an otherwise normal knee: a retrospective review of functional, clinical, and radiographic results

A retrospective review of patients who underwent arthroscopic partial lateral meniscectomy for lateral meniscus tears in otherwise normal knees was conducted to review the long-term functional, clinical, and radiographic results. Twenty-six patients (27 knees) were evaluated by questionnaire; 20 patients (21 knees) also underwent physical examination and radiographic analysis. Minimum follow-up was 5 years and mean follow-up was 8 years. Patient data were obtained from detailed questionnaires, knee examinations, and radiographs. Excellent or good results decreased from 92% at the time of maximal improvement to 62% at the most recent follow-up: 85% of patients were initially able to return to their preinjury activity level; however, only 48% were able to maintain this level of activity at the most recent follow-up. Seventy-two percent of patients had either one or no Fairbank changes and there was no statistical difference when comparing radiographic criteria in the operated and nonoperated knee. Early results for partial lateral meniscectomy can be quite good; however, significant deterioration of functional results and decreased activity level can occur. Radiographic changes did not correlate with subjective sumptoms and functional outcome in our patient population. Our findings suggest that the functional outcome for patietns undergoing partial lateral meniscectomy may deteriorate with time and it may be helpful to counsel patients concerning long-term expectations.

Long-term effects of arthroscopic partial lateral meniscectomy in an otherwise normal knee: A retrospective review of functional, clinical, and radiographic results

Long-term effects of arthroscopic partial lateral meniscectomy in an otherwise normal knee: A retrospective review of functional, clinical, and radiographic results

Arthroscopic partial meniscectomy: 5-year follow-up.

The purpose of this study was to determine the influence of preexisting chondromalacia at time of surgery on the results at a minimum of 5 years follow-up of arthroscopic partial meniscectomy. The patients were divided into two groups: group I (87 patients, average age 29.8 years) with no intraoperative findings of chondromalacia at the time of surgery, and group II (234 patients, average age 39.2 years) with chondromalacia at the time of surgery. The follow-up period was 70-86 months, with the criterion of a minimum of 5 years in each patient. Postoperative changes were evaluated according to Fairbank's classification and preoperative X-rays were compared to follow-up X-rays. For statistical analysis the Mann-Whitney test was used. In both groups arthroscopic partial lateral meniscectomy led to worse results in respect of the development of osteoarthritis. Following partial medial meniscectomy preexisting chondromalacia had a negative influence on the radiological outcome. An increase of osteoarthritis was also proven in our patient population which was statistically significantly related to age and female sex (P = 0.002).

Arthroscopic treatment of the discoid lateral meniscus: Results of long-term follow-up

Twenty-two patients (25 knees) were evaluated at an average follow-up of 54 months for clinical results of arthroscopic treatment of the discoid lateral meniscus syndrome. Discoid lateral menisci were classified arthroscopically as incomplete (92%) or complete (8%); no Wrisberg-type lesions were noted. Three patients (14%) had bilateral lesions. Symptomatic torn discoid menisci (20 knees) and torn discoid menisci with other significant symptomatic lesions (3 knees) underwent arthroscopic partial lateral meniscectomy utilizing the saucerization technique. Asymptomatic intact discoid menisci (2 knees) were left unresected. Using the knee scale of Ikeuchi, 55% of the symptomatic torn lesions were rated as excellent or good, 30% were rated as fair, and 15% were rated as poor at follow-up. Two of the 3 asymptomatic torn lesions were rated as excellent or good, as were both of the intact discoid lesions. Factors associated with an unsatisfactory rating at follow-up included preexistent degenerative changes, age, and sex. Duration of symptoms, type of discoid tear, and length of follow-up were not necessarily related to outcome results. Seven knees (28%) required arthroscopic reevaluation at a postoperative average of 23 months, documenting apparent physiologic function of the saucerized rim in 4 patients and failure of saucerization in 3 patients (12%). Overall, 14 of the 22 patients in this study (64%) resumed a normal activity level postoperatively, including 61% of those with symptomatic torn discoid lateral menisci.

Arthroscopic partial meniscectomy in patients aged over 50.

The Journal of Bone and Joint Surgery. British volumeVol. 68-B, No. 5 ArticlesFree AccessArthroscopic partial meniscectomy in patients aged over 50S Boe, H HansenS BoeSearch for more papers by this author, H HansenSearch for more papers by this authorPublished Online:1 Nov 1986https://doi.org/10.1302/0301-620X.68B5.3782228AboutSectionsPDF/EPUB ToolsAdd to FavouritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited BySensitivity of Standing Radiographs to Detect Knee Arthritis: A Systematic Review of Level I StudiesArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 31, No. 2Risk Factors for Short-term Adverse Events and Readmission After Arthroscopic Meniscectomy7 October 2014 | The American Journal of Sports Medicine, Vol. 43, No. 1Cross-sectional Analysis of Trends in Meniscectomy and Meniscus RepairOrthopedics, Vol. 36, No. 8Complications of Arthroscopic Meniscectomy in the Older Population10 April 2012 | The American Journal of Sports Medicine, Vol. 40, No. 6Arthroscopic Partial Meniscectomy: MR Imaging for Prediction of Outcome in Middle-Aged and Elderly PatientsRadiology, Vol. 259, No. 1An Arthroscopic Treatment Regimen for Osteoarthritis of the KneeArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 23, No. 9Factors predicting functional and radiographic outcomes after arthroscopic partial meniscectomy: A review of the literatureArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 21, No. 2A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-upArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 19, No. 8Knee arthroscopy in the older patientOperative Techniques in Orthopaedics, Vol. 12, No. 2Arthroscopic partial meniscectomy in patients over 70 years of ageArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 17, No. 7MRI Modifications After Ho-2.1 Laser Knee ArthroscopyMeniscal Tears in the Athlete: Operative and Nonoperative ManagementPhysical Medicine and Rehabilitation Clinics of North America, Vol. 11, No. 4Arthroskopische MeniskusresektionEvaluation of Arthroscopic Techniques and Osteotomies in GonarthritisKniegelenk — Spezieller TeilARTHROSCOPIC TREATMENT OF THE DEGENERATIVE KNEE IN OLDER ATHLETESClinics in Sports Medicine, Vol. 16, No. 1The effects of arthroscopic partial lateral meniscectomy in an otherwise normal knee: a retrospective review of functional, clinical, and radiographic resultsArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 11, No. 1Arthroscopic partial meniscectomyOperative Techniques in Orthopaedics, Vol. 5, No. 1Why a rheumatologist should be interested in arthroscopyArthritis & Rheumatism, Vol. 37, No. 11Roentgenographic changes after arthroscopic meniscectomy: Five-year follow-up in patients more than 45 years oldArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 8, No. 2ARTHROSCOPIC TREATMENT OF DEGENERATIVE JOINT DISEASE OF THE KNEEOrthopedics, Vol. 14, No. 12Results of Arthroscopic MeniscectomyClinics in Sports Medicine, Vol. 9, No. 3Arthroscopy and degenerative arthritis of the knee: A review of the literatureArthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 6, No. 1 Vol. 68-B, No. 5 Metrics Downloaded 30 times History Published online 1 November 1986 Published in print 1 November 1986 InformationCopyright © 1986, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download