J Korean Orthop Assoc.  2008 Feb;43(1):86-92. 10.4055/jkoa.2008.43.1.86.

A Study on the Development of Degenerative Osteoarthritis after Arthroscopic Total Menisectomy

Affiliations
  • 1Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea. kyoungho@khmc.or.kr
  • 2Department of Orthopedic Surgery, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea.

Abstract

PURPOSE: This study compared the clinical and radiological incidence of osteoarthritis after a total meniscectomy.
MATERIALS AND METHODS
Seventy eight patients, who underwent a total meniscectomy, were evaluated after a minimum follow up of five years. The operations were a medial meniscectomy (group I) in 16 cases, a lateral meniscectomy (group II) in 17 cases, a discoid meniscus (group III) in 29 cases and medial meniscectomy with an anterior cruciate ligament reconstruction (group IV) in 16 cases. The development of degenerative osteoarthritis was analyzed using the Kaplan-Meyer survivorship.
RESULTS
At postoperative 5 years and 7 years, degenerative osteoarthritis developed in 17% and 36% of patients, respectively. The incidence ofdegenerative osteoarthritis at postoperative 5 years and 7 years in groups I, II, III and IV was 9% and 18%, 14% and 29%, 25% and 46%, and 28% and 55%, respectively. The difference was statistically significant.
CONCLUSION
The meniscus deficient knee joint which varies according to the patterns of a meniscal injury, had a higher incidence of degenerative osteoarthritis. Careful attention should be paid to the treatment of meniscal tears.

Keyword

Knee; Degenerative osteoarthritis; Meniscal injury; Total meniscectomy

MeSH Terms

Anterior Cruciate Ligament Reconstruction
Follow-Up Studies
Humans
Incidence
Knee
Knee Joint
Osteoarthritis

Figure

  • Fig. 1 An anteroposterior radiograph, which was obtained eight years after the meniscectomy, showed a ridge along the margin of the lateral femoral condyle (arrow) in the left knee.

  • Fig. 2 Overall development of degenerative osteoarthritis after a total meniscecomy estimated by Kaplan-Meyer survivorship analysis.

  • Fig. 3 Different pattern of degenerative osteoarthritis according to groups after a total meniscectomy. Discrimination in the rate of arthritic change was observed. *Group I medial meniscectomy; Group II lateral meniscectomy; Group III meniscectomy on discoid meniscus; Group IV medial meniscectomy with ACL reconstruction.

  • Fig. 4 (A) Group II had a tendency to show degenerative change earlier than in Group I after a total meniscectomy (p<0.05, log rank test). (B) The same comparison of Group II with III. Group III had a tendency to show degenerative changes earlier than Group II (p<0.05). (C) Same comparison of Group III with IV. Group IV had a tendency to show degenerative change earlier than Group III (p<0.05).


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