Clinical and radiographic results of arthroscopic partial meniscectomy
Hayrettin Kesmezacar1, Rıfat Erginer1, Tahir Ögüt1, Ali Uzpak1, Turgut Dinçal1, Günay Can2, Muharrem Babacan1
1Departments of Orthopedics and Traumatology, Cerrahpaşa Medicine Faculty of İstanbul University, İstanbul
2Departments of Public Health, Cerrahpaşa Medicine Faculty of İstanbul University, İstanbul
Keywords: Arthroscopy; knee injuries/surgery; knee joint/radiography; menisci, tibial/injuries/surgery.
Objectives: The purpose of this study was to evaluate the results of the arthroscopic partial meniscectomy and to investigate correlations between preoperative findings and the clinical and radiographic results.
Patients and methods: The study included 49 patients (49 knees; 28 females, 21 males; mean age 42 years; range 16 to 68 years) who underwent arthroscopic partial meniscectomy for medial (n=39) or lateral (n=10) meniscus tears. Thirty patients (61.2%) were over 40 years of age at the time of surgery. Final evaluations were made at the end of a mean follow-up of 62.7 months (range 31 to 109 months) with preoperative and postoperative Lysholm scores, Tegner activity scores, standing anteroposterior x-rays of both knees, and subjective evaluation of the patients. Radiographic evaluations were made separately for medial and lateral meniscectomy groups. The femorotibial axis, medial and lateral clear spaces, and the degree of degeneration according to the Fairbank criteria were determined and compared with the contralateral side.
Results: Functional results were excellent in 29 knees (59.2%), good in 17 knees (34.7%), and poor in three knees (6.1%). The mean Lysholm score showed a significant improvement from 52.4 to 94.5 postoperatively (p<0.01). The results were better in patients under 40 years of age and in those without articular cartilage damage. Final radiographs showed a trend to varus and valgus in the medial and lateral meniscectomy groups, respectively. Compared with the contralateral side, significant narrowing of the medial joint space was detected in the operated knees after medial meniscectomy (p<0.05).
Conclusion: Early functional and subjective results of arthroscopic partial meniscectomy are satisfactory. However, radiographic narrowing of the joint space and angulation to the varus may pose further problems in the long-term.