Outcomes at 20 years after meniscectomy in young patients |
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| Affiliation: | 1. School of Medicine, University of Turin, Turin, Italy;2. Villa Maria Pia Hospital, Turin, Italy;1. Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan;2. Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan;3. Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan;1. Lahore General Hospital, Lahore, Pakistan;2. Liaquat National Hospital, Karachi, Pakistan;3. Akbar Niazi Teaching Hospital, Islamabad, Pakistan;1. NorthWest Clinics, Department of Orthopaedic Surgery, Alkmaar, the Netherlands;2. Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam, the Netherlands;3. Spaarne Gasthuis, Department of Orthopaedic Surgery, Hoofddorp, the Netherlands;4. Medical Clinics Velsen, Department of Orthopaedic Surgery, Velsen, the Netherlands;5. Amsterdam UMC, University of Amsterdam, Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, the Netherlands;6. Amsterdam UMC, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), University of Amsterdam and Vrije Universiteit Amsterdam IOC Research Center, Amsterdam, the Netherlands;1. Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom;2. University of the West of England, Bristol BS16 1QL, United Kingdom |
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| Abstract: | AimTo define arthroscopic meniscectomy (AM) outcomes in young patients at 20 years follow up in terms of predictors of poor clinical results, rate and timing of conversion to total knee replacement (TKR).MethodsThe following data were collected for 225 patients aged between 18 and 50 years with meniscal tear (MT) who underwent AM: age at surgery, gender, injured meniscus, knee alignment, associated lesions, amount of meniscal resection. At 20 years follow up, rate and timing of TKR conversion and clinical outcomes with Knee injury and Osteoarthritis Outcome Score (KOOS) score were reviewed.ResultsTen patients (4.4%) required TKR in the follow up period. The mean time from AM to TKR was 7.0 years (standard deviation 3.87). Age between 40 and 50 years at AM (P < 0.01), malalignment (P < 0.01), lateral meniscectomy (any size, P = 0.01), advanced chondral lesion (Outerbridge > 2, P < 0.01) and total meniscectomy (P < 0.01) were significantly related to subsequent TKR. Negative predicting factors to obtaining equal or superior to age/sex-adjusted KOOS score were age between 40 and 50 years old at time of AM (P < 0.01), female sex (P < 0.01), malalignment (P = 0.04), and advanced chondral lesion (Outerbridge > 2, P = 0.02).ConclusionsTwenty years conversion rate to TKR after AM for MT is 4.4% and TKR was performed after a mean time of 7 years. Significant association between TKR surgery and advanced chondral lesion (Outerbridge > 2), total meniscectomy, lateral meniscectomy, age at surgery between 40 and 50 years old, and malalignment were found. Age between 40 and 50 years at time of AM, female, malalignment, advanced chondral lesion were all factors significantly related to poor clinical results. |
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| Keywords: | Arthroscopic meniscectomy Total knee replacement Meniscal tears Lateral meniscectomy Chondral lesion Knee malalignment |
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