A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up |
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| Institution: | 1. Department of Orthopaedic Surgery, Hokkaido Orthopaedic Memorial Hospital, Sapporo, Japan;2. Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan;3. Center for Advanced Medical Engineering and Informatics, Osaka University, Suita, Osaka, Japan;1. University of São Paulo, Post-Graduation Program Interunits Bioengineering EESC/FMRP/IQSC-USP, São Carlos, Brazil;2. CAPES Foundation, Ministry of Education of Brazil, Brasília, DF 70.040-020, Brazil;3. Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia;4. Research Laboratory of Exercise Science, The Brazilian Navy, Rio de Janeiro, Brazil;5. University of São Paulo State, School of Science and Technology, Physical Therapy Department, Presidente Prudente, Brazil;1. Department of Orthopaedic Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, 21, Namdong-daero 774 beon-gil, Namdong-gu, Incheon, Republic of Korea;2. Department of Orthopaedic Surgery, Armed Forces Capital Hospital, Seongnam, Gyeonggi-do, 81, Saemaeul-ro 177 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea;3. Department of Orthopaedic Surgery, Chungnam Nationl University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea |
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| Abstract: | Purpose: Our goal was to compare results of partial medial arthroscopic meniscectomy with results of partial lateral arthroscopic meniscectomy and to determine prognostic factors. Type of Study: Retrospective comparative study with statistical analysis. Methods: In this study, 362 medial and 109 lateral isolated arthroscopic meniscectomies are presented with a minimum follow-up time of 10 years. All knees were stable with no previous surgery or traumatic lesion. Results: In this study, 95% of the patients were very satisfied or satisfied with the results of the medial meniscectomy, and 95.5% with results of the lateral meniscectomy (P = .32). According to grades 1 and 2 of the Intenational Knee Documentation Committee (IKDC) form, 85.8% of the medial meniscectomy group were free of any symptoms, as were 79.7% of the lateral meniscectomy group (P = .11). Radiologic changes after medial and lateral meniscectomy were found in 21.5% and 37.5%, respectively (P = .11). The rates of radiologic changes in patients in whom the contralateral knee was radiologically normal were 22.3% and 39%, respectively (P = .016). The rate of repeat surgeries for osteoarthritis was less than 0.2%. Conclusions: Subjective and clinical results after medial or lateral meniscectomy are quite similar, but radiologic results are significantly worse after lateral meniscectomy. The most accurate way to determine the degeneration caused by the meniscectomy is to evaluate joint space narrowing in patients in whom the contralateral knee was radiologically normal. Otherwise, partial medial or lateral meniscectomy are well tolerated. A better prognosis can be predicted for a patient with an isolated medial meniscal tear with one or more of the following factors: age less than 35 years, a vertical tear, no cartilage damage, and an intact meniscal rim at the end of the meniscectomy. With an isolated lateral meniscal tear, a better prognosis can be predicted if the patient is young and has an intact meniscal rim at the end of the meniscectomy. |
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