J H Ahn1, D M Kang2, K J Choi2. 1. Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, 814 Siksadong, Ilsandonggu, Goyangsi, Gyeonggido, South Korea. Electronic address: drsky71@duih.org. 2. Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, 814 Siksadong, Ilsandonggu, Goyangsi, Gyeonggido, South Korea.
Abstract
INTRODUCTION: Partial meniscectomy has been preferred in the treatment of discoid lateral meniscus (DLM) with tear, rather than total or subtotal meniscectomy, which could lead to late radiographic degenerative changes. HYPOTHESIS: One or more risk factors contribute to radiographic progression of osteoarthritis after partial meniscectomy of DLM tear. MATERIAL AND METHODS: Inclusion criteria were consecutive patients who underwent arthroscopic surgeries for DLM tear from January 2005 to December 2010 by one surgeon. Exclusion criteria were preoperative osteoarthritis with KL grade 3 or more, osteochondritis dissecans, minimal width of meniscal remnant less than 6mm after meniscectomy, meniscal repair of an unstable discoid meniscus, age over 60years, loss to follow-up for a minimum of 5years and simultaneous surgery on articular cartilage or anterior cruciate ligament. According to the KL grade at the last follow-up, all enrolled knees were sorted into no progression to knee osteoarthritis (KL grade 1 or 2 - NOA) and progression to osteoarthritis (KL grade 3 or 4 - POA) groups. Multivariate logistic regression was used to analyze the risk factors of high-grade osteoarthritis. RESULTS: In comparison with NOA group (n=135) and POA group (n=67), prolonged symptom duration, increased relative percentage of DLM thickness (RPDT) and the presence of horizontal tear were significant risk factors. The presence of horizontal tear (P=0.048, adjusted OR=19.364) was the strongest predictor, compared with prolonged symptom duration (P=0.030, adjusted OR=1.150) and increased RPDT (P=0.003, adjusted OR=1.377). DISCUSSION: Horizontal tear, prolonged symptom duration, and increased RPDT are significant risk factors for radiographic progression to high-grade osteoarthritis after partial meniscectomy of DLM tear with a minimum follow-up of 5years. LEVEL OF EVIDENCE: III, case-control study.
INTRODUCTION: Partial meniscectomy has been preferred in the treatment of discoid lateral meniscus (DLM) with tear, rather than total or subtotal meniscectomy, which could lead to late radiographic degenerative changes. HYPOTHESIS: One or more risk factors contribute to radiographic progression of osteoarthritis after partial meniscectomy of DLM tear. MATERIAL AND METHODS: Inclusion criteria were consecutive patients who underwent arthroscopic surgeries for DLM tear from January 2005 to December 2010 by one surgeon. Exclusion criteria were preoperative osteoarthritis with KL grade 3 or more, osteochondritis dissecans, minimal width of meniscal remnant less than 6mm after meniscectomy, meniscal repair of an unstable discoid meniscus, age over 60years, loss to follow-up for a minimum of 5years and simultaneous surgery on articular cartilage or anterior cruciate ligament. According to the KL grade at the last follow-up, all enrolled knees were sorted into no progression to knee osteoarthritis (KL grade 1 or 2 - NOA) and progression to osteoarthritis (KL grade 3 or 4 - POA) groups. Multivariate logistic regression was used to analyze the risk factors of high-grade osteoarthritis. RESULTS: In comparison with NOA group (n=135) and POA group (n=67), prolonged symptom duration, increased relative percentage of DLM thickness (RPDT) and the presence of horizontal tear were significant risk factors. The presence of horizontal tear (P=0.048, adjusted OR=19.364) was the strongest predictor, compared with prolonged symptom duration (P=0.030, adjusted OR=1.150) and increased RPDT (P=0.003, adjusted OR=1.377). DISCUSSION: Horizontal tear, prolonged symptom duration, and increased RPDT are significant risk factors for radiographic progression to high-grade osteoarthritis after partial meniscectomy of DLM tear with a minimum follow-up of 5years. LEVEL OF EVIDENCE: III, case-control study.
Authors: Nathan L Grimm; James Lee Pace; Benjamin J Levy; D'Ann Arthur; Mark Portman; Matthew J Solomito; Jennifer M Weiss Journal: Orthop J Sports Med Date: 2020-09-17
Authors: Joseph M Brutico; Margaret L Wright; Sarah I Kamel; Adam C Zoga; Kirsten Poehling-Monaghan; Sommer Hammoud Journal: Orthop J Sports Med Date: 2021-12-17
Authors: Peter Kurzweil; Aaron J Krych; Adam Anz; F Winston Gwathmey; Gregory Loren; Matthew Lavery; David C Flanigan Journal: Arthrosc Sports Med Rehabil Date: 2021-03-13