Top

Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-01-2015 | Knee

Cartilage degeneration and not age influences the health-related quality of life outcome after partial meniscectomy

Authors: Michael C. Liebensteiner, Michael Nogler, Johannes M. Giesinger, Ricarda Lechner, Florian Lenze, Martin Thaler

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2015

Abstract

Purpose

The purpose of this study is to investigate whether inconsistently reported factors influence the health-related quality of life (HRQOL) outcome of partial meniscectomy.

Method

Short Form 36 (SF-36) data on 216 patients were retrospectively analysed for the influence of the factors age, gender and degree of cartilage degeneration. Mixed linear models were applied for univariate and multivariate analyses.

Results

All SF-36 scales, including the psychosocial scales, showed a significant improvement from pre- to post-operative (p < 0.001). The factor ‘degree of cartilage degeneration’ was found to significantly influence post-surgical improvement of the SF-36 ‘physical component summary’ score. Patients with mild cartilage degeneration benefited significantly more from surgery than did patients with advanced cartilage degeneration (p = 0.011). Older patients had significantly lower scores on each subscale, but showed no significant age–time interaction, that is, no association was seen between age and the degree of improvement. No effect was determined for the variable gender.

Conclusions

The findings of the current study can be interpreted to show that arthroscopic partial meniscectomy significantly improves HRQOL, even in mental or psychosocial dimensions of HRQOL. Not age but the degree of cartilage degeneration influences the HRQOL gain that can be expected. The factor gender has no effect on HRQOL. The findings of our study influence our daily routine, in that we take the degree of cartilage degeneration and not age as predictive value for the success to be anticipated from the procedure. Concerning the preoperative consenting, it is important to mention that advanced cartilage degeneration is a predictor of a less favourable outcome.

Level of evidence

IV.

Bolano LE, Grana WA (1993) Isolated arthroscopic partial meniscectomy. Functional radiographic evaluation at five years. Am J Sports Med 21:432–437PubMedCrossRef

Burks RT, Metcalf MH, Metcalf RW (1997) Fifteen-year follow-up of arthroscopic partial meniscectomy. Arthroscopy 13:673–679PubMedCrossRef

Busija L, Osborne RH, Nilsdotter A, Buchbinder R, Roos EM (2008) Magnitude and meaningfulness of change in SF-36 scores in four types of orthopedic surgery. Health Qual Life Outcomes 6:55PubMedCentralPubMedCrossRef

Chatain F, Adeleine P, Chambat P, Neyret P (2003) A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 19:842–849PubMedCrossRef

Desai VV, Ackroyd CE (2000) Resection of degenerate menisci—is it useful? Knee 7:179–182PubMedCrossRef

Englund M, Lohmander LS (2004) Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthr Rheum 50:2811–2819CrossRef

Englund M, Paradowski PT, Lohmander LS (2004) Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy. Arthr Rheum 50:469–475CrossRef

Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. Arthr Rheum 48:2178–2187CrossRef

Englund M, Roos EM, Roos HP, Lohmander LS (2001) Patient-relevant outcomes fourteen years after meniscectomy: influence of type of meniscal tear and size of resection. Rheumatol (Oxf) 40:631–639CrossRef

10.

Ericsson YB, Ringsberg K, Dahlberg LE (2011) Self-efficacy, physical activity and health-related quality of life in middle-aged meniscectomy patients and controls. Scand J Med Sci Sports 21:e150–e158PubMedCrossRef

11.

Group TE (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16:199–208CrossRef

12.

Hede A, Larsen E, Sandberg H (1992) The long term outcome of open total and partial meniscectomy related to the quantity and site of the meniscus removed. Int Orthop 16:122–125PubMedCrossRef

13.

Hede A, Larsen E, Sandberg H (1992) Partial versus total meniscectomy. A prospective, randomised study with long-term follow-up. J Bone Joint Surg Br 74:118–121PubMed

14.

Higuchi H, Kimura M, Shirakura K, Terauchi M, Takagishi K (2000) Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res:161-168

15.

ICRS cartilage injury evaluation pack. International Cartilage Repair Society. http://www.cartilage.org

16.

Jorgensen U, Sonne-Holm S, Lauridsen F, Rosenklint A (1987) Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. J Bone Joint Surg Br 69:80–83PubMed

17.

Maletius W, Messner K (1996) Chondral damage and age depress the long-term prognosis after partial meniscectomy. A 12 to 15-year follow-up study. Knee Surg Sports Traumatol Arthrosc 3:211–214PubMedCrossRef

18.

Maletius W, Messner K (1996) The effect of partial meniscectomy on the long-term prognosis of knees with localized, severe chondral damage. A twelve- to fifteen-year followup. Am J Sports Med 24:258–262PubMedCrossRef

19.

Matsusue Y, Thomson NL (1996) Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5 to 11-year follow-up study. Arthroscopy 12:39–44PubMedCrossRef

20.

Morrissey MC, Milligan P, Goodwin PC (2006) Evaluating treatment effectiveness: benchmarks for rehabilitation after partial meniscectomy knee arthroscopy. Am J Phys Med Rehabil 85:490–501PubMedCrossRef

21.

Paradowski PT, Englund M, Lohmander LS, Roos EM (2005) The effect of patient characteristics on variability in pain and function over two years in early knee osteoarthritis. Health Qual Life Outcomes 3:59PubMedCentralPubMedCrossRef

22.

Rockborn P, Gillquist J (1996) Long-term results after arthroscopic meniscectomy. The role of preexisting cartilage fibrillation in a 13 year follow-up of 60 patients. Int J Sports Med 17:608–613PubMedCrossRef

23.

Roos EM, Ostenberg A, Roos H, Ekdahl C, Lohmander LS (2001) Long-term outcome of meniscectomy: symptoms, function, and performance tests in patients with or without radiographic osteoarthritis compared to matched controls. Osteoarthritis Cartilage 9:316–324PubMedCrossRef

24.

Roos EM, Roos HP, Ryd L, Lohmander LS (2000) Substantial disability 3 months after arthroscopic partial meniscectomy: A prospective study of patient-relevant outcomes. Arthroscopy 16:619–626PubMedCrossRef

25.

Salata MJ, Gibbs AE, Sekiya JK (2010) A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med 38:1907–1916PubMedCrossRef

26.

Small NC, Sledge CB, Katz JN (1994) A conceptual framework for outcomes research in arthroscopic meniscectomy: results of a nominal group process. Arthroscopy 10:486–492PubMedCrossRef

27.

Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483PubMedCrossRef

Title: Cartilage degeneration and not age influences the health-related quality of life outcome after partial meniscectomy
Authors: Michael C. Liebensteiner
Michael Nogler
Johannes M. Giesinger
Ricarda Lechner
Florian Lenze
Martin Thaler
Publication date: 01-01-2015
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-013-2478-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cartilage degeneration and not age influences the health-related quality of life outcome after partial meniscectomy

Abstract

Purpose

Method

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusions

Level of evidence

Please log in to get access to this content

Other articles of this Issue 1/2015

MR-arthrography assessment after repair of chronic meniscal tears

A systematic review of the incidence and clinical significance of postoperative meniscus transplant extrusion

Medial meniscus anatomy—from basic science to treatment

Influence of partial meniscectomy on attachment forces, superficial strain and contact mechanics in porcine knee joints

Meniscal translation during knee flexion: what do we really know?

Successful conservative treatment of patients with MRI-verified meniscal lesions