Long-term results of meniscus repair and meniscectomy: a 13-year functional and radiographic follow-up study.

This study investigated the long-term outcome of common meniscus treatment (meniscectomy, repair). A consecutive series of 30 patients with open meniscus repair were compared retrospectively to 30 patients who had an arthroscopic partial or subtotal meniscectomy. The groups were matched according to sex, age, meniscus lesion, and follow-up time. The patients were aged 13-43 years at the time of operation; all had intact cruciate ligaments, and none had had previous surgery on the knee. Patients were reexamined at a mean of 13 years after the operation. In addition, for a subgroup of 22 matched pairs, data were available from a 7-year follow-up. Four of the repaired menisci did not heal, and another three reruptured during the 13-year follow-up; these menisci were all excised (23%). Meniscal remnant surgery was needed in 6 cases (20%) after initial meniscectomy. At the 13-year follow-up there was no difference between the groups in knee function, subjective complaints, or manual findings. Almost 90% of the patients in both groups had no knee problems during daily activities. At the late follow-up radiographic signs for bone spurs, sclerosis, or flattening of the femoral condyle were found in around half of the cases in each group. Three patients (10%) with initial repair and 8 (27%) with meniscectomy had minor joint space reduction, but no patient had more severe radiographic changes. After 7 years (subgroup) joint space reduction was more common after initial meniscectomy than after repair (P < 0.05). After 13 years the incidence and severity of arthrosis did not differ significantly between the two groups, even when only the successful repairs were compared to meniscectomy (P = 0.06).