The aim of the present study was to analyse which clinical, radiological and arthroscopic findings are able to predict the postoperative outcome after arthroscopic partial meniscectomy. Furthermore, the present study aimed to investigate the postoperative outcome after partial meniscectomy in patients with degenerative meniscal lesions.
A total of 91 patients with a follow-up period of 34.7 ± 11.4 months after arthroscopic partial meniscectomy were included in this retrospective study. Clinical, radiological, and arthroscopic data were analysed at the time of follow-up. The multivariable linear regression analysis for postoperative outcome, based on the Western Ontario Meniscal Evaluation Tool (WOMET), included age, gender, body mass index, physical activity, presence of cartilage lesions, leg alignment, grade of radiographic osteoarthritis, location of meniscal lesions, meniscal extrusion, meniscal degeneration, presence of an anterior cruciate ligament tears as well as bone marrow lesions.
WOMET and WOMAC scores showed a significant improvement of 45.0 ± 48.1 points (CI 34.9–55.1; p ≤ 0.0001) and 75.1 ± 69.3 points (CI 60.6–89.6; p = 0.001) within the follow-up period. Multivariable linear regression analysis showed that poor preoperative WOMET scores (p = 0.001), presence of cartilage lesions at the medial femoral condylus (p = 0.001), meniscal degeneration (p = 0.008), the presence of an anterior cruciate ligament lesion (p = 0.005), and lateral meniscal tears (p = 0.039) were associated with worse postoperative outcomes. Patients with femoral bone marrow lesions had better outcome (p = 0.038).
Poor preoperative WOMET scores, presence of cartilage lesions at the medial femoral condylus, meniscal degeneration, concomitant anterior cruciate ligament lesions as well as lateral meniscal tears are correlated with worse postoperative outcomes after arthroscopic partial meniscectomy. Patients with femoral bone marrow lesions femoral are more likely to gain benefit from arthroscopic partial meniscectomy in the middle term. Despite justified recent restrictions in indication, arthroscopic partial meniscectomy seems to effectively reduce pain and alleviate symptoms in carefully selected patients with degenerative meniscal tears.
Level of evidence
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Andersson-Molina H, Karlsson H, Rockborn P (2002) Arthroscopic partial and total meniscectomy: a long-term follow-up study with matched controls. Arthroscopy 18:183–189
Beaufils P, Becker R, Kopf S, Englund M, Verdonk R, Ollivier M, Seil R (2017) Surgical management of degenerative meniscus lesions: the 2016 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc 25:335–346
Beaufils P, Becker R, Verdonk R, Aagaard H, Karlsson J (2015) Focusing on results after meniscus surgery. Knee Surg Sports Traumatol Arthrosc 23:3–7
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840
Bisson LJ, Phillips P, Matthews J, Zhou Z, Zhou J, Wind WM, Fineberg MS, Bernas GA, Rauh MA, Marzo JM, Kluczynski MA (2019) Association between bone marrow lesions, chondral lesions, and pain in patients without radiographic evidence of degenerative joint disease who underwent arthroscopic partial meniscectomy. Orthop J Sports Med 7:2325967119830381
Burks RT, Metcalf MH, Metcalf RW (1997) Fifteen-year follow-up of arthroscopic partial meniscectomy. Arthroscopy 13:673–679
Chatain F, Adeleine P, Chambat P, Neyret P, d’Arthroscopie Société Française (2003) A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 19:842–849
Colombet P, Dejour D, Panisset J-C, Siebold R, French Arthroscopy Society (2010) Current concept of partial anterior cruciate ligament ruptures. Orthop Traumatol Surg Res 96:S109–S118
Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? AJR Am J Roentgenol 183:17–23
Ding C, Martel-Pelletier J, Pelletier J-P, Abram F, Raynauld J-P, Cicuttini F, Jones G (2007) Knee meniscal extrusion in a largely non-osteoarthritic cohort: association with greater loss of cartilage volume. Arthr Res Ther 9:R21
Doyle DJ, Garmon EH (2018) American Society of Anesthesiologists Classification (ASA Class). StatPearls StatPearls Publishing, Treasure Island
Englund M, Lohmander LS (2004) Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthr Rheum 50:2811–2819
Englund M, Niu J, Guermazi A, Roemer FW, Hunter DJ, Lynch JA, Lewis CE, Torner J, Nevitt MC, Zhang YQ, Felson DT (2007) Effect of meniscal damage on the development of frequent knee pain, aching, or stiffness. Arthr Rheum 56:4048–4054
Englund M, Roemer FW, Hayashi D, Crema MD, Guermazi A (2012) Meniscus pathology, osteoarthritis and the treatment controversy. Nat Rev Rheumatol 8:412–419
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 24:769–778
Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR (2001) The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med 134:541–549
Ganderup T, Jensen C, Holsgaard-Larsen A, Thorlund JB (2017) Recovery of lower extremity muscle strength and functional performance in middle-aged patients undergoing arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc 25:347–354
Gauffin H, Sonesson S, Meunier A, Magnusson H, Kvist J (2017) Knee arthroscopic surgery in middle-aged patients with meniscal symptoms: a 3-year follow-up of a prospective, randomized study. Am J Sports Med 45:2077–2084
Guyatt GH, Mills EJ, Elbourne D (2008) In the era of systematic reviews, does the size of an individual trial still matter? PLoS Med 5:e4
Hare KB, Lohmander LS, Christensen R, Roos EM (2013) Arthroscopic partial meniscectomy in middle-aged patients with mild or no knee osteoarthritis: a protocol for a double-blind, randomized sham-controlled multi-centre trial. BMC Musculoskelet Disord 14:71
Harrington IJ (1983) Static and dynamic loading patterns in knee joints with deformities. J Bone Joint Surg Am 65:247–259
Haviv B, Bronak S, Kosashvili Y, Thein R (2016) 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. Knee Surg Sports Traumatol Arthrosc 24:1427–1431
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 16:122–125
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 74:118–121
Herrlin SV, Wange PO, Lapidus G, Hållander M, Werner S, Weidenhielm L (2013) Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five-year follow-up. Knee Surg Sports Traumatol Arthrosc 21:358–364
Higuchi H, Kimura M, Shirakura K, Terauchi M, Takagishi K (2000) Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res 377:161–168
Hoemann C, Kandel R, Roberts S, Saris DBF, Creemers L, Mainil-Varlet P, Méthot S, Hollander AP, Buschmann MD (2011) International Cartilage Repair Society (ICRS) recommended guidelines for histological endpoints for cartilage repair studies in animal models and clinical trials. Cartilage 2:153–172
Hong SH, Choi J-Y, Lee GK, Choi J-A, Chung HW, Kang HS (2003) Grading of anterior cruciate ligament injury. Diagnostic efficacy of oblique coronal magnetic resonance imaging of the knee. J Comput Assist Tomogr 27:814–819
Hunter DJ, Guermazi A, Lo GH, Grainger AJ, Conaghan PG, Boudreau RM, Roemer FW (2011) Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthr Cartil 19:990–1002
Jørgensen 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 69:80–83
Karpinski K, Müller-Rath R, Niemeyer P, Angele P, Petersen W (2019) Subgroups of patients with osteoarthritis and medial meniscus tear or crystal arthropathy benefit from arthroscopic treatment. Knee Surg Sports Traumatol Arthrosc 27:782–796
Katz JN, Meredith DS, Lang P, Creel AH, Yoshioka H, Neumann G, Fossel AH, de Pablo P, Losina E (2006) Associations among preoperative MRI features and functional status following arthroscopic partial meniscectomy. Osteoarthr Cartil 14:418–422
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
Kijowski R, Woods MA, McGuine TA, Wilson JJ, Graf BK, De Smet AA (2011) Arthroscopic partial meniscectomy: MR imaging for prediction of outcome in middle-aged and elderly patients. Radiology 259:203–212
Kim JG, Lee S-Y, Chay S, Lim HC, Bae J-H (2016) Arthroscopic meniscectomy for medial meniscus horizontal cleavage tears in patients under age 45. Knee Surg Relat Res 28:225–232
Kim S-J, Choi CH, Chun Y-M, Kim S-H, Lee S-K, Jang J, Jeong H, Jung M (2017) Relationship between preoperative extrusion of the medial meniscus and surgical outcomes after partial meniscectomy. Am J Sports Med 45:1864–1871
Kirshner B, Guyatt G (1985) A methodological framework for assessing health indices. J Chronic Dis 38:27–36
Kise NJ, Risberg MA, Stensrud S, Ranstam J, Engebretsen L, Roos EM (2016) Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two-year follow-up. BMJ 354:i3740
Lerer DB, Umans HR, Hu MX, Jones MH (2004) The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skelet Radiol 33:569–574
Link TM, Steinbach LS, Ghosh S, Ries M, Lu Y, Lane N, Majumdar S (2003) Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. Radiology 226:373–381
Lyu S-R (2015) Why arthroscopic partial meniscectomy? Ann Transl Med 3:217
Muheim LLS, Senn O, Früh M, Reich O, Rosemann T, Neuner-Jehle SM (2017) Inappropriate use of arthroscopic meniscal surgery in degenerative knee disease. Acta Orthop 88:550–555
Paley D, Pfeil J (2000) Principles of deformity correction around the knee. Orthopade 29:18–38
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 17:608–613
Rongen JJ, van Tienen TG, Buma P, Hannink G (2018) Meniscus surgery is still widely performed in the treatment of degenerative meniscus tears in The Netherlands. Knee Surg Sports Traumatol Arthrosc 26:1123–1129
Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96
Seil R, Karlsson J, Beaufils P, Becker R, Kopf S, Ollivier M, Denti M (2017) The difficult balance between scientific evidence and clinical practice: the 2016 ESSKA meniscus consensus on the surgical management of degenerative meniscus lesions. Knee Surg Sports Traumatol Arthrosc 25:333–334
Sgroi M, Däxle M, Kocak S, Reichel H, Kappe T (2017) Translation, validation, and cross-cultural adaption of the Western Ontario Meniscal Evaluation Tool (WOMET) into German. Knee Surg Sports Traumatol Arthrosc 26(8):2332–2337
Sihvonen R, Järvelä T, Aho H, Järvinen TLN (2012) Validation of the Western Ontario Meniscal Evaluation Tool (WOMET) for patients with a degenerative meniscal tear: a meniscal pathology-specific quality-of-life index. J Bone Joint Surg Am 94:e65
Sihvonen R, Paavola M, Malmivaara A, Itälä A, Joukainen A, Nurmi H, Kalske J, Ikonen A, Järvelä T, Järvinen TAH, Kanto K, Karhunen J, Knifsund J, Kröger H, Kääriäinen T, Lehtinen J, Nyrhinen J, Paloneva J, Päiväniemi O, Raivio M, Sahlman J, Sarvilinna R, Tukiainen S, Välimäki V-V, Äärimaa V, Toivonen P, Järvinen TLN, FIDELITY (Finnish Degenerative Meniscal Lesion Study) Investigators (2018) Arthroscopic partial meniscectomy versus placebo surgery for a degenerative meniscus tear: a 2-year follow-up of the randomised controlled trial. Ann Rheum Dis 77:188–195
Sofu H, Oner A, Camurcu Y, Gursu S, Ucpunar H, Sahin V (2016) Predictors of the clinical outcome after arthroscopic partial meniscectomy for acute trauma-related symptomatic medial meniscal tear in patients more than 60 years of age. Arthroscopy 32:1125–1132
Stensrud S, Risberg MA, Roos EM (2014) Knee function and knee muscle strength in middle-aged patients with degenerative meniscal tears eligible for arthroscopic partial meniscectomy. Br J Sports Med 48:784–788
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
Thorlund JB, Englund M, Christensen R, Nissen N, Pihl K, Jørgensen U, Schjerning J, Lohmander LS (2017) Patient reported outcomes in patients undergoing arthroscopic partial meniscectomy for traumatic or degenerative meniscal tears: comparative prospective cohort study. BMJ 356:j356
Willinger L, Lang JJ, von Deimling C, Diermeier T, Petersen W, Imhoff AB, Burgkart R, Achtnich A (2019) Varus alignment increases medial meniscus extrusion and peak contact pressure: a biomechanical study. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-019-05701-1
Wirth B, Meier N, Koch PP, Swanenburg J (2013) Development and evaluation of a German version of the Tegner activity scale for measuring outcome after anterior cruciate ligament injury. Sportverletz Sportschaden 27:21–27
Conflict of interest
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Each author certifies that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. More specifically, none of the authors received payments or services, either directly or indirectly (i.e. via his or her institution), from a third party in support of any aspect of this work. Also, all authors declare that they have had no other relationships, or have been engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
This study was approved by the institutional review board of the University of Ulm (ID-number: 43/14).
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Sgroi, M., Gninka, J., Fuchs, M. et al. Chondral lesions at the medial femoral condyle, meniscal degeneration, anterior cruciate ligament insufficiency, and lateral meniscal tears impair the middle-term results after arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc (2020). https://doi.org/10.1007/s00167-020-05883-z
- Meniscal tear
- Partial meniscectomy