Danyal H Nawabi1, Suzie Cro2, Imran P Hamid3, Andy Williams4. 1. Hospital for Special Surgery, New York, New York, USA nawabid@hss.edu. 2. Medical Research Council Clinical Trials Unit, London, UK. 3. Chelsea and Westminster Hospital, London, UK. 4. Chelsea and Westminster Hospital, London, UK Fortius Clinic, London, UK.
Abstract
BACKGROUND: Meniscectomy is frequently performed in elite soccer athletes to allow return to a high level of performance as early as possible. Although lateral meniscectomy is known to have more serious long-term sequelae than medial meniscectomy, little is known about the effect of lateral meniscectomy on the time to return to play during the early recovery phase in professional soccer players. HYPOTHESIS: Lateral meniscectomy results in longer times to return to preinjury level of competition and a higher incidence of adverse outcomes compared with medial meniscectomy in elite professional soccer players. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A single-surgeon database containing the injury history and operative details of elite soccer athletes from 2005 to 2009 was used to identify players who had undergone an isolated partial lateral or medial meniscectomy. The time to return to preinjury level of competition, the incidence of adverse events during early recovery, and the need for further arthroscopy were recorded. Time to return to play was analyzed by using the Kaplan-Meier method. A multivariate analysis was used to control for age, location of meniscectomy, percentage of meniscus excised, and type of tear. RESULTS: Ninety soccer players were identified, of which 42 had a lateral meniscectomy and 48 had a medial meniscectomy. The median time to return to play, to the nearest week, was longer in the lateral group than the medial group (7 vs 5; P < .001). At all time points after surgery, the cumulative probability of returning to play was 5.99 times greater (95% confidence interval, 3.34-10.74; P < .001) after medial meniscectomy. More lateral meniscectomy cases experienced adverse events related to pain/swelling-29 (69%) vs 4 (8%) (P < .001)-and required a second arthroscopy: 3 (7%) vs 0 (P = .098). CONCLUSION: The time to return to preinjury level of competition is significantly longer after lateral than medial meniscectomy in elite professional soccer athletes. Lateral meniscectomy has a higher incidence of adverse events in the early recovery period, including pain/swelling and the need for further arthroscopy. It is also associated with a significantly lower rate of return to play. These findings form the basis of an important discussion that must be had with player and club before a lateral meniscectomy is performed in elite soccer athletes.
BACKGROUND: Meniscectomy is frequently performed in elite soccer athletes to allow return to a high level of performance as early as possible. Although lateral meniscectomy is known to have more serious long-term sequelae than medial meniscectomy, little is known about the effect of lateral meniscectomy on the time to return to play during the early recovery phase in professional soccer players. HYPOTHESIS: Lateral meniscectomy results in longer times to return to preinjury level of competition and a higher incidence of adverse outcomes compared with medial meniscectomy in elite professional soccer players. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A single-surgeon database containing the injury history and operative details of elite soccer athletes from 2005 to 2009 was used to identify players who had undergone an isolated partial lateral or medial meniscectomy. The time to return to preinjury level of competition, the incidence of adverse events during early recovery, and the need for further arthroscopy were recorded. Time to return to play was analyzed by using the Kaplan-Meier method. A multivariate analysis was used to control for age, location of meniscectomy, percentage of meniscus excised, and type of tear. RESULTS: Ninety soccer players were identified, of which 42 had a lateral meniscectomy and 48 had a medial meniscectomy. The median time to return to play, to the nearest week, was longer in the lateral group than the medial group (7 vs 5; P < .001). At all time points after surgery, the cumulative probability of returning to play was 5.99 times greater (95% confidence interval, 3.34-10.74; P < .001) after medial meniscectomy. More lateral meniscectomy cases experienced adverse events related to pain/swelling-29 (69%) vs 4 (8%) (P < .001)-and required a second arthroscopy: 3 (7%) vs 0 (P = .098). CONCLUSION: The time to return to preinjury level of competition is significantly longer after lateral than medial meniscectomy in elite professional soccer athletes. Lateral meniscectomy has a higher incidence of adverse events in the early recovery period, including pain/swelling and the need for further arthroscopy. It is also associated with a significantly lower rate of return to play. These findings form the basis of an important discussion that must be had with player and club before a lateral meniscectomy is performed in elite soccer athletes.
Authors: William A Zuke; Avinesh Agarwalla; Beatrice Go; Justin W Griffin; Brian J Cole; Nikhil N Verma; Bernard R Bach; Brian Forsythe Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-06-28 Impact factor: 4.342
Authors: Kyle A Borque; Mary Jones; Moises Cohen; Darren Johnson; Andy Williams Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-08-20 Impact factor: 4.342
Authors: Avinesh Agarwalla; Anirudh K Gowd; Joseph N Liu; Simon P Lalehzarian; David R Christian; Brian J Cole; Brian Forsythe; Nikhil N Verma Journal: Orthop J Sports Med Date: 2019-04-25