Medium-Term Results of Arthroscopic Partial Meniscectomy from a Single High-Volume Center

Indian J Orthop. 2020 Feb 28;54(3):358-365. doi: 10.1007/s43465-019-00018-0. eCollection 2020 May.

Abstract

Aim: Clinical practice is moving away from treating meniscal tears in patients with osteoarthritis unless there are mechanical symptoms. This study assessed the risk of needing further surgery for osteoarthritis in the 5 years following partial meniscectomy in different age groups and different grades of knee osteoarthritis.

Methods: All partial meniscectomies were performed by the senior author during a 31-month period. Data were collected and analyzed retrospectively using electronic patients' records and imaging database. Patients who had previous arthroscopy, anterior cruciate ligament pathology, discoid meniscus or were less than 34 years old were excluded from the study. Range of follow-up was 3 to 5 years. Osteoarthritis was classified intra-operatively using the Outerbridge classification. Knees that needed further surgical treatment in the form of joint replacement or osteotomy were considered as failures. The population was split into three groups according to their age (35-54, 55-64 and 65+). Survival analysis was calculated using the life table method.

Results: 207 knees were included. In the 35-54 age group, patients with no/mild OA had a survival rate of 97.59% and the severe OA group had a survival rate of 73.5%. In the 55-64 age group, these figures were 100% and 73.6%, respectively. In the >65 age group, the survival rates were 100% and 65%, respectively.

Conclusion: Our study shows that patients with no/mild OA should be considered for APM. Patient's with meniscal tears and severe OA should be counseled on the outcomes and risks of further surgery after an APM.

Keywords: Age; Knee; Osteoarthritis; Partial meniscectomy; Progression of osteoarthritis.