Failed meniscal repair increases the risk for osteoarthritis and poor knee function at an average of 9 years follow-up

Knee Surg Sports Traumatol Arthrosc. 2022 Jan;30(1):192-199. doi: 10.1007/s00167-021-06442-w. Epub 2021 Feb 6.

Abstract

Purpose: The purpose of this study was to determine the effect of meniscal repair on OA in the knee joint and patient-related outcomes.

Methods: Three-hundred and sixteen meniscal repairs performed between 1999 and 2011 were analysed. Patient-related outcome measures were assessed through mailed questionnaires including KOOS, Lysholm score and Tegner activity level. Patients answering the questionnaires were encouraged to perform a radiographic evaluation with Rosenberg views, assessed according to Kellgren-Lawrence (KL) classification. The primary endpoint was to determine the effect of meniscal repair on the development of radiographic OA defined as a KL grade 2 or more.

Results: Mean follow-up time was 9.3 years (SD 3.6), 162 (51%) patients answered the questionnaires, and 86 patients completed the X-ray. The odds ratio for OA with a failed meniscus repair was 5.1 (p = 0.007) adjusted for gender and age at time of follow-up. KOOS showed a clinically important difference in the sport and recreation subscale (p = 0.041).

Conclusions: There was an increased risk for OA in the affected compartment with a failed meniscus fixation. This supports the fact that the meniscus is an important protector of the cartilage in the knee. The meniscus injury affects the long-term health-related quality of life according to KOOS and in light of this study we recommend repair of a torn meniscus whenever possible.

Level of evidence: III.

Keywords: ACL reconstruction; Meniscus injury; Meniscus repair; Osteoarthritis; Patient-reported outcome.

MeSH terms

  • Anterior Cruciate Ligament Injuries* / surgery
  • Anterior Cruciate Ligament Reconstruction*
  • Follow-Up Studies
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery
  • Menisci, Tibial / diagnostic imaging
  • Menisci, Tibial / surgery
  • Osteoarthritis*
  • Osteoarthritis, Knee* / surgery
  • Quality of Life