Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticlesArthroscopic partial meniscectomy in patients over 70 years of age*
Section snippets
Methods
Between 1992 and 1996, 97 patients older than 70 years underwent arthroscopic partial meniscectomy at our clinic. At the time of evaluation, 5 patients had died and 1 patient was unavailable, leaving 91 patients (95 knees) entered in the study. There were 56 women and 35 men. The average age at time of surgery was 74 years (range, 70 to 84 years). The mean follow-up period was 4 years (range, 2 to 6 years).
The time between onset of symptoms and arthroscopic treatment varied from 1 to 12 months
Results
At follow-up of 2 years or longer, 81% of the patients with osteoarthritis grade 0-2 and 83% of the patients with cartilage damage grade 0-2 presented a satisfactory outcome (Table 1). NOTE. 45% of patients with grade 3-4 osteoarthritis and 37% of patients with grade 3-4 cartilage damage went on to further surgery, usually a total knee arthroplasty.Empty Cell Grade 0-1-2 Grade 3-4 Osteoarthritis (Kellgren & Lawrence grading) 81% 55% Cartilage damage (Outerbridge grading) 83% 69%
Discussion
Pre-existing degenerative articular changes have often been reported as the most important predicting factor for the outcome following arthroscopic partial meniscectomy in the elderly.3, 4, 6, 7, 8, 9 Furthermore, if some reported better outcome in patients with recent trauma history,6, 10, 13 they often compared these patients with another group of patients with degenerative meniscal tears or osteoarthritis. In fact, these studies were also advocating the importance of the degenerative
Conclusion
Our results suggest that the outcome after arthroscopic partial meniscectomy seems to be more affected by pre-existing degenerative changes than by the patient’s age. However, it is possible to obtain satisfactory results in patients over 70 years old (more than two thirds of all our cases) even in the presence of mild to moderate degenerative articular changes. Furthermore, if cartilage changes do not exceed grade 2 according to Outerbridge, or if the radiologic evidence of osteoarthritis does
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Cited by (34)
Radiographic evaluation of knee osteoarthritis in predicting outcomes after arthroscopic partial meniscectomy
2020, KneeCitation Excerpt :Our weighted kappa for KL grading was even lower at 0.30, perhaps because our study cohort included a lower prevalence of severe OA cases; more severe cases are easier to identify and grade. The lower prevalence of severe OA in our study was the natural result of including only patients who had undergone APM, as surgeons are reluctant to offer APM as a treatment option to patients with severe OA given the known relationship between severe OA and poor outcomes [3,6,7,14]. The higher inter-reader agreement observed with mJSW grading in our study (agreement values for the medial and lateral compartments of 72.7% and 90.9%, respectively) is also in concordance with results from previous research.
Incidence and predictors of total knee arthroplasty following knee arthroscopy
2018, Journal of OrthopaedicsArthroscopic Partial Meniscectomy or Conservative Treatment for Nonobstructive Meniscal Tears: A Systematic Review and Meta-analysis of Randomized Controlled Trials
2016, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :In the literature, APM has been suggested as a risk factor for the development and progression of OA.27-35 How this influences physical function after surgery remains unclear.27,36-38 One study described the progression of OA after both treatments in the long term (60 months) and found no differences between the groups on radiological examination.19
Creep behavior of the intact and meniscectomy knee joints
2011, Journal of the Mechanical Behavior of Biomedical MaterialsCitation Excerpt :This missing information may be needed to understand joint disease and injury since the knee functions as a central load-bearing mechanism. Clinical studies have demonstrated cartilage damage in a few years after the total or partial meniscectomy (Crevoisier et al., 2001; Jackson, 1968; McNicholas et al., 2000). Fibrillation, flattening and formation of femoral cartilage, especially close to the sites of meniscus removal, were among the changes that might have caused cartilage degeneration leading to osteoarthritis (DiStefano, 1980; Roos et al., 1998; Tapper and Hoover, 1969).
Unfavorable results of partial meniscectomy for complete posterior medial meniscus root tear with early osteoarthritis: A 5- to 8-year follow-up study
2010, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :Of the 46 patients, 9 underwent reoperation (4 of 34 patients with Outerbridge grades 0, I, and II and 5 of 12 patients with Outerbridge grades III and IV), with unicondylar knee arthroplasty performed in 5 cases and medial opening wedge high tibia osteotomy performed in another 4 cases for persistent signs and symptoms. Various reports have confirmed that partial meniscectomy yields satisfactory results in patients with meniscal tears.4,14,21-26 Literature is lacking regarding the results of partial meniscectomy for complete PMMRT.
The Use of Hylan G-F 20 After Knee Arthroscopy in an Active Patient Population With Knee Osteoarthritis
2008, Arthroscopy - Journal of Arthroscopic and Related Surgery
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Address correspondence and reprint requests to Xavier Crevoisier, M.D., Hôpital Orthopédique de la Suisse Romande, Pierre-Decker 4, CH-1005 Lausanne, Switzerland. E-mail: [email protected]