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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2016

01-05-2016 | Knee

Which patients are less likely to improve during the first year after arthroscopic partial meniscectomy? A multivariate analysis of 201 patients with prospective follow-up

Authors: Barak Haviv, Shlomo Bronak, Yona Kosashvili, Rafael Thein

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2016

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Abstract

Purpose

To determine which specific factors influence the improvements in function and pain at the first year following arthroscopic partial meniscectomy.

Methods

Between 2012 and 2013, patients who had arthroscopic partial meniscectomy were included (n = 201) and followed prospectively before surgery and at 12 months. Multivariable stepwise analysis included preoperative variables (age, gender, limb side, height, weight, body mass index, comorbidities, smoking, Tegner activity scale, Lysholm knee score, preceding injury and duration of preoperative symptoms) and arthroscopic findings (degree of cartilage lesions, medial or lateral meniscus involvement, type of meniscal tear and concomitant cruciate tear). The Lysholm clinical score at the last follow-up and the time interval for substantial pain relief was modelled as a function of the above predictor variables.

Results

At the last follow-up, the mean Lysholm score improved by 14.6 points (95 % CI 10.4–18.8, P < 0.001), from 68.0 ± 16.1 to 82.6 ± 19.6 points and 153 (76 %) patients declared they were satisfied to have had the operation. The mean time interval for substantial pain relief was 3.5 ± 1.5 months. Females and patients with lower preoperative Lysholm score were correlated with lower post-operative Lysholm score, while females and patients with lateral meniscal tears (compared to medial meniscal tears) were correlated with longer recovery.

Conclusions

Arthroscopic partial meniscectomy improved pain and function at the first year post-operatively. Female gender, lateral meniscal tear and less favourable preoperative function were relatively correlated to worse post-operative function and longer rehabilitation time.

Level of evidence

IV.
Literature
1.
go back to reference Briggs KK, Kocher MS, Rodkey WG, Steadman JR (2006) Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 88:698–705CrossRefPubMed Briggs KK, Kocher MS, Rodkey WG, Steadman JR (2006) Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 88:698–705CrossRefPubMed
2.
go back to reference Brittberg M, Winalski CS (2003) Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 85:58–69PubMed Brittberg M, Winalski CS (2003) Evaluation of cartilage injuries and repair. J Bone Joint Surg Am 85:58–69PubMed
3.
go back to reference Burks RT, Metcalf MH, Metcalf RW (1997) Fifteen-year follow-up of arthroscopic partial meniscectomy. Arthroscopy 13:673–679CrossRefPubMed Burks RT, Metcalf MH, Metcalf RW (1997) Fifteen-year follow-up of arthroscopic partial meniscectomy. Arthroscopy 13:673–679CrossRefPubMed
4.
go back to reference 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. Arthritis Rheumatol 48:2178–2187CrossRef 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. Arthritis Rheumatol 48:2178–2187CrossRef
5.
go back to reference Erdil M, Bilsel K, Sungur M et al (2013) Does obesity negatively affect the functional results of arthroscopic partial meniscectomy? A retrospective cohort study. Arthroscopy 29:232–237CrossRefPubMed Erdil M, Bilsel K, Sungur M et al (2013) Does obesity negatively affect the functional results of arthroscopic partial meniscectomy? A retrospective cohort study. Arthroscopy 29:232–237CrossRefPubMed
6.
go back to reference Fabricant PD, Jokl P (2007) Surgical outcomes after arthroscopic partial meniscectomy. J Am Acad Orthop Surg 15:647–653CrossRefPubMed Fabricant PD, Jokl P (2007) Surgical outcomes after arthroscopic partial meniscectomy. J Am Acad Orthop Surg 15:647–653CrossRefPubMed
7.
go back to reference Fabricant PD, Rosenberger PH, Jokl P, Ickovics JR (2008) Predictors of short-term recovery differ from those of long-term outcome after arthroscopic partial meniscectomy. Arthroscopy 24:769–778CrossRefPubMedPubMedCentral Fabricant PD, Rosenberger PH, Jokl P, Ickovics JR (2008) Predictors of short-term recovery differ from those of long-term outcome after arthroscopic partial meniscectomy. Arthroscopy 24:769–778CrossRefPubMedPubMedCentral
8.
go back to reference Faunø P, Nielsen AB (1992) Arthroscopic partial meniscectomy: a long-term followup. Arthroscopy 8:345–349CrossRefPubMed Faunø P, Nielsen AB (1992) Arthroscopic partial meniscectomy: a long-term followup. Arthroscopy 8:345–349CrossRefPubMed
9.
go back to reference Herrlin SV, Wange PO, Lapidus G (2013) Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up. Knee Surg Sports Traumatol Arthrosc 21:358–364CrossRefPubMed Herrlin SV, Wange PO, Lapidus G (2013) Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up. Knee Surg Sports Traumatol Arthrosc 21:358–364CrossRefPubMed
10.
go back to reference Higuchi H, Kimura M, Shirakura K, Terauchi M, Takagishi K (2000) Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res 377:161–168CrossRefPubMed Higuchi H, Kimura M, Shirakura K, Terauchi M, Takagishi K (2000) Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res 377:161–168CrossRefPubMed
12.
go back to reference Kobayashi M, Nakamura S, Arai R et al (2009) Cartilage damage severity predicts clinical results after partial meniscectomy for horizontal degenerative tear of medial meniscus. Osteoarthr Cartil 17:S166CrossRef Kobayashi M, Nakamura S, Arai R et al (2009) Cartilage damage severity predicts clinical results after partial meniscectomy for horizontal degenerative tear of medial meniscus. Osteoarthr Cartil 17:S166CrossRef
13.
go back to reference Matsusue Y, Thomson NL (1996) Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5- to 11-year follow-up study. Arthroscopy 12:39–44CrossRefPubMed Matsusue Y, Thomson NL (1996) Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5- to 11-year follow-up study. Arthroscopy 12:39–44CrossRefPubMed
14.
15.
go back to reference Meredith D, Losina E, Mahomed NN, Wright J, Katz JN (2005) Factors predicting functional and radiographic outcomes after arthroscopic partial meniscectomy: a review of the literature. Arthroscopy 21:211–223CrossRefPubMed Meredith D, Losina E, Mahomed NN, Wright J, Katz JN (2005) Factors predicting functional and radiographic outcomes after arthroscopic partial meniscectomy: a review of the literature. Arthroscopy 21:211–223CrossRefPubMed
16.
go back to reference Rockborn P, Gillquist J (1995) Outcome of arthroscopic meniscectomy. A 13-year physical and radiographic follow-up of 43 patients under 23 years of age. Acta Orthop Scand 66:113–117CrossRefPubMed Rockborn P, Gillquist J (1995) Outcome of arthroscopic meniscectomy. A 13-year physical and radiographic follow-up of 43 patients under 23 years of age. Acta Orthop Scand 66:113–117CrossRefPubMed
17.
go back to reference Roos E, 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. Osteoarthr Cartil 9:316–324CrossRefPubMed Roos E, 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. Osteoarthr Cartil 9:316–324CrossRefPubMed
18.
go back to reference Salata MJ, Gibbs AE, Sekiya JK (2010) A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med 38:1907–1916CrossRefPubMed Salata MJ, Gibbs AE, Sekiya JK (2010) A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med 38:1907–1916CrossRefPubMed
19.
go back to reference Sihvonen R, Paavola M, Malmivaara A et al (2013) Finnish Degenerative Meniscal Lesion Study (FIDELITY) group. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 369:2515–2524CrossRefPubMed Sihvonen R, Paavola M, Malmivaara A et al (2013) Finnish Degenerative Meniscal Lesion Study (FIDELITY) group. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 369:2515–2524CrossRefPubMed
20.
go back to reference Umar M (1997) Ambulatory arthroscopic knee surgery results of partial meniscectomy. JPMA 47:210–213 Umar M (1997) Ambulatory arthroscopic knee surgery results of partial meniscectomy. JPMA 47:210–213
Metadata
Title
Which patients are less likely to improve during the first year after arthroscopic partial meniscectomy? A multivariate analysis of 201 patients with prospective follow-up
Authors
Barak Haviv
Shlomo Bronak
Yona Kosashvili
Rafael Thein
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3590-z

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