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

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

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

III.

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Authors

Contributions

MS participated in the design of the study, collected the data, performed the statistical analysis, and wrote the manuscript. JG helped during statistical analysis. MF and AS helped to draft the manuscript and participated in its correction. HR participated in the study design and coordination, helped to design the manuscript. TK developed the study design, participated in its design and coordination, and helped to draft the manuscript.

Corresponding author

Correspondence to Mirco Sgroi.

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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.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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This study was approved by the institutional review board of the University of Ulm (ID-number: 43/14).

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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 28, 3488–3496 (2020). https://doi.org/10.1007/s00167-020-05883-z

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Keywords

  • WOMET
  • Meniscal tear
  • Partial meniscectomy
  • Outcome
  • Predictors