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Published in: Archives of Orthopaedic and Trauma Surgery 9/2016

01-09-2016 | Arthroscopy and Sports Medicine

Arthroscopic meniscectomy of traumatic versus atraumatic tears in middle aged patients: is there a difference?

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

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2016

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Abstract

Introduction

Meniscal tears can be classified in various ways, one of which is into traumatic or degenerative. It is not known whether partial meniscectomy of clinically defined traumatic compared to degenerative tears in middle age patients has favorable results. The purpose of this study was to compare the outcome after arthroscopic partial meniscectomy of clinically defined traumatic to degenerative meniscal tears in middle age patients.

Materials and methods

Eighty-six middle aged patients with stable knees and no radiographic signs of osteoarthritis who had arthroscopic partial meniscectomy were divided into a study group of 43 patients with a preceding knee injury related to their knee symptoms (traumatic group) and a control group of 43 uninjured patients (atraumatic group), matched by age, sex, body mass index and comorbidities. The surgical findings and postoperative clinical scores were compared between the two groups.

Results

There were no statistical differences in surgical findings of tear types and degree of chondral lesions. At the end of the follow-up 33 (77 %) patients in each group were satisfied to have had the operation. The median Lysholm score improved from 65.9 ± 17.4 to 77.4 ± 21.2 points (P = 0.001) in the traumatic group and from 65.3 ± 17 to 82.4 ± 17.7 in the atraumatic group (P < 0.0001).

Conclusions

Arthroscopic partial meniscectomy in middle aged patients with stable knees and no signs of radiographic osteoarthritis improve pain and function. There were no differences in surgical findings and short term clinical outcome between patients with and without preceding knee injury.
Literature
1.
go back to reference Garrett WE Jr, Swiontkowski MF, Weinstein JN, Callaghan J, Rosier RN, Berry DJ et al (2006) American board of orthopaedic surgery practice of the orthopaedic surgeon: Part-II, certification examination case mix. J Bone Joint Surg Am 88:660–667CrossRefPubMed Garrett WE Jr, Swiontkowski MF, Weinstein JN, Callaghan J, Rosier RN, Berry DJ et al (2006) American board of orthopaedic surgery practice of the orthopaedic surgeon: Part-II, certification examination case mix. J Bone Joint Surg Am 88:660–667CrossRefPubMed
2.
go back to reference Matsusue Y, Thomson NL (1996) Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5-to 11-year followup 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 followup study. Arthroscopy 12:39–44CrossRefPubMed
3.
go back to reference Greis PE, Bardana DD, Holmstrom MC, Burks RT (2002) Meniscal injury: I. Basic science and evaluation. J Am Acad Orthop Surg 10:168–176CrossRefPubMed Greis PE, Bardana DD, Holmstrom MC, Burks RT (2002) Meniscal injury: I. Basic science and evaluation. J Am Acad Orthop Surg 10:168–176CrossRefPubMed
4.
go back to reference Mather RC 3rd, Garrett WE, Cole BJ et al (2015) Cost-effectiveness analysis of the diagnosis of meniscus tears. Am J Sports Med 43(1):128–137CrossRefPubMed Mather RC 3rd, Garrett WE, Cole BJ et al (2015) Cost-effectiveness analysis of the diagnosis of meniscus tears. Am J Sports Med 43(1):128–137CrossRefPubMed
6.
go back to reference Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a 16-year followup of meniscectomy with matched controls. Arthritis Rheum 48(8):2178–2187CrossRefPubMed Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a 16-year followup of meniscectomy with matched controls. Arthritis Rheum 48(8):2178–2187CrossRefPubMed
7.
go back to reference Sihvonen R, Paavola M, Malmivaara A, Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group et al (2013) Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 369:2515–2524CrossRefPubMed Sihvonen R, Paavola M, Malmivaara A, Finnish Degenerative Meniscal Lesion Study (FIDELITY) Group et al (2013) Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 369:2515–2524CrossRefPubMed
8.
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
9.
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 88:698–705CrossRef 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 88:698–705CrossRef
10.
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
11.
go back to reference Englund M, Guermazi A, Lohmander SL (2009) The role of the meniscus in knee osteoarthritis: a cause or consequence? Radiol Clin North Am 47(4):703–712CrossRefPubMed Englund M, Guermazi A, Lohmander SL (2009) The role of the meniscus in knee osteoarthritis: a cause or consequence? Radiol Clin North Am 47(4):703–712CrossRefPubMed
12.
go back to reference Englund M (2008) The role of the meniscus in osteoarthritis genesis. Rheum Dis Clin North Am 34(3):573–579CrossRefPubMed Englund M (2008) The role of the meniscus in osteoarthritis genesis. Rheum Dis Clin North Am 34(3):573–579CrossRefPubMed
13.
go back to reference Englund M, Roos EM, Roos HP, Lohmander LS (2001) Patient-relevant outcomes 14 years after meniscectomy: influence of type of meniscal tear and size of resection. Rheumatology 40(6):631–639CrossRefPubMed Englund M, Roos EM, Roos HP, Lohmander LS (2001) Patient-relevant outcomes 14 years after meniscectomy: influence of type of meniscal tear and size of resection. Rheumatology 40(6):631–639CrossRefPubMed
14.
go back to reference Meister K, Indelicato PA, Spanier S, Franklin J, Batts J (2004) Histology of the torn meniscus: a comparison of histologic differences in meniscal tissue between tears in anterior cruciate ligament-intact and anterior cruciate ligament-deficient knees. Am J Sports Med 32(6):1479–1483CrossRefPubMed Meister K, Indelicato PA, Spanier S, Franklin J, Batts J (2004) Histology of the torn meniscus: a comparison of histologic differences in meniscal tissue between tears in anterior cruciate ligament-intact and anterior cruciate ligament-deficient knees. Am J Sports Med 32(6):1479–1483CrossRefPubMed
15.
go back to reference Noble J (1977) Lesions of the menisci. Autopsy incidence in adults less than 55 years old. J Bone Joint Surg Am 59(4):480–483PubMed Noble J (1977) Lesions of the menisci. Autopsy incidence in adults less than 55 years old. J Bone Joint Surg Am 59(4):480–483PubMed
16.
go back to reference Lewandrowski KU, Muller J, Schollmeier G (1997) Concomitant meniscal and articular cartilage lesions in the femorotibial joint. Am J Sports Med 25(4):486–494CrossRefPubMed Lewandrowski KU, Muller J, Schollmeier G (1997) Concomitant meniscal and articular cartilage lesions in the femorotibial joint. Am J Sports Med 25(4):486–494CrossRefPubMed
17.
go back to reference Poehling GG, Ruch DS, Chabon SJ (1990) The landscape of meniscal injuries. Clin Sports Med 9(3):539–549PubMed Poehling GG, Ruch DS, Chabon SJ (1990) The landscape of meniscal injuries. Clin Sports Med 9(3):539–549PubMed
18.
go back to reference Metcalf MH, Barrett GR (2004) Prospective evaluation of 1485 meniscal tear patterns in patients with stable knees. Am J Sports Med 32(3):675–680CrossRefPubMed Metcalf MH, Barrett GR (2004) Prospective evaluation of 1485 meniscal tear patterns in patients with stable knees. Am J Sports Med 32(3):675–680CrossRefPubMed
19.
go back to reference Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M et al (2008) Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 359(11):1108–1115CrossRefPubMedPubMedCentral Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M et al (2008) Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med 359(11):1108–1115CrossRefPubMedPubMedCentral
20.
go back to reference Ding C, Martel-Pelletier J, Pelletier JP, Abram F, Raynauld JP, Cicuttini F et al (2007) Meniscal tear as an osteoarthritis risk factor in a largely non-osteoarthritic cohort: a cross-sectional study. J Rheumatol 34(4):776–784PubMed Ding C, Martel-Pelletier J, Pelletier JP, Abram F, Raynauld JP, Cicuttini F et al (2007) Meniscal tear as an osteoarthritis risk factor in a largely non-osteoarthritic cohort: a cross-sectional study. J Rheumatol 34(4):776–784PubMed
21.
go back to reference Rytter S, Jensen LK, Bonde JP, Jurik AG, Egund N (2009) Occupational kneeling and meniscal tears: a magnetic resonance imaging study in floor layers. J Rheumatol 36(7):1512–1519CrossRefPubMed Rytter S, Jensen LK, Bonde JP, Jurik AG, Egund N (2009) Occupational kneeling and meniscal tears: a magnetic resonance imaging study in floor layers. J Rheumatol 36(7):1512–1519CrossRefPubMed
22.
go back to reference Holibkova A, Machalek L, Holibka R, Chromek Z (1989) Lesions of the knee joint menisci in miners. Acta Univ Palacki Olomuc Fac Med 123:147–168PubMed Holibkova A, Machalek L, Holibka R, Chromek Z (1989) Lesions of the knee joint menisci in miners. Acta Univ Palacki Olomuc Fac Med 123:147–168PubMed
23.
go back to reference Christoforakis J, Pradhan R, Sanchez-Ballester J, Hunt N, Strachan RK (2005) Is there an association between articular cartilage changes and degenerative meniscus tears? Arthroscopy 21(11):1366–1369CrossRefPubMed Christoforakis J, Pradhan R, Sanchez-Ballester J, Hunt N, Strachan RK (2005) Is there an association between articular cartilage changes and degenerative meniscus tears? Arthroscopy 21(11):1366–1369CrossRefPubMed
24.
go back to reference Tsai L, Wredmark T (1993) Arthroscopic surgery of the knee in local anaesthesia. An analysis of age-related pathology. Arch Orthop Trauma Surg 112(3):136–138CrossRefPubMed Tsai L, Wredmark T (1993) Arthroscopic surgery of the knee in local anaesthesia. An analysis of age-related pathology. Arch Orthop Trauma Surg 112(3):136–138CrossRefPubMed
25.
go back to reference Osti L, Liu SH, Raskin A, Merlo F, Bocchi L (1994) Partial lateral meniscectomy in athletes. Arthroscopy 10(4):424–430CrossRefPubMed Osti L, Liu SH, Raskin A, Merlo F, Bocchi L (1994) Partial lateral meniscectomy in athletes. Arthroscopy 10(4):424–430CrossRefPubMed
26.
go back to reference Menetrey J, Siegrist O, Fritschy D (2002) Medial meniscectomy in patients over the age of 50: a 6 year follow-up study. Swiss Surg 8(3):113–119CrossRefPubMed Menetrey J, Siegrist O, Fritschy D (2002) Medial meniscectomy in patients over the age of 50: a 6 year follow-up study. Swiss Surg 8(3):113–119CrossRefPubMed
27.
go back to reference Fauno P, Nielsen AB (1992) Arthroscopic partial meniscectomy: a long-term follow-up. Arthroscopy 8(3):345–349CrossRefPubMed Fauno P, Nielsen AB (1992) Arthroscopic partial meniscectomy: a long-term follow-up. Arthroscopy 8(3):345–349CrossRefPubMed
28.
go back to reference Shelbourne KD, Carr DR (2003) Meniscal repair compared with meniscectomy for bucket-handle medial meniscal tears in anterior cruciate ligament-reconstructed knees. Am J Sports Med 31(5):718–723PubMed Shelbourne KD, Carr DR (2003) Meniscal repair compared with meniscectomy for bucket-handle medial meniscal tears in anterior cruciate ligament-reconstructed knees. Am J Sports Med 31(5):718–723PubMed
Metadata
Title
Arthroscopic meniscectomy of traumatic versus atraumatic tears in middle aged patients: is there a difference?
Authors
Barak Haviv
Shlomo Bronak
Yona Kosashvili
Rafael Thein
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 9/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-016-2504-y

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