A Study on the Development of Degenerative Osteoarthritis after Arthroscopic Total Menisectomy

Bi O Jeong; Kyoung Ho Yoon; Dae Kyung Bae; Dong Hun Lee

doi:10.4055/jkoa.2008.43.1.86

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Jeong, Yoon, Bae, and Lee: A Study on the Development of Degenerative Osteoarthritis after Arthroscopic Total Menisectomy

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(1): 86-92.

Published online: 29 February 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.1.86

A Study on the Development of Degenerative Osteoarthritis after Arthroscopic Total Menisectomy

Bi O Jeong, M.D., Kyoung Ho Yoon, M.D., Dae Kyung Bae, M.D., Dong Hun Lee, M.D.^*

Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

^*Department of Orthopedic Surgery, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea.

Address reprint requests to Kyoung Ho Yoon, M.D. Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +82.2-958-8350, Fax: +82.2-964-3865, kyoungho@khmc.or.kr

Abstract

Purpose

This study compared the clinical and radiological incidence of osteoarthritis after a total meniscectomy.

Materials and Methods

Seventy eight patients, who underwent a total meniscectomy, were evaluated after a minimum follow up of five years. The operations were a medial meniscectomy (group I) in 16 cases, a lateral meniscectomy (group II) in 17 cases, a discoid meniscus (group III) in 29 cases and medial meniscectomy with an anterior cruciate ligament reconstruction (group IV) in 16 cases. The development of degenerative osteoarthritis was analyzed using the Kaplan-Meyer survivorship.

Results

At postoperative 5 years and 7 years, degenerative osteoarthritis developed in 17% and 36% of patients, respectively. The incidence ofdegenerative osteoarthritis at postoperative 5 years and 7 years in groups I, II, III and IV was 9% and 18%, 14% and 29%, 25% and 46%, and 28% and 55%, respectively. The difference was statistically significant.

Conclusion

The meniscus deficient knee joint which varies according to the patterns of a meniscal injury, had a higher incidence of degenerative osteoarthritis. Careful attention should be paid to the treatment of meniscal tears.

Keywords: Knee, Degenerative osteoarthritis, Meniscal injury, Total meniscectomy

Figures and Tables

Fig. 1

An anteroposterior radiograph, which was obtained eight years after the meniscectomy, showed a ridge along the margin of the lateral femoral condyle (arrow) in the left knee.

Fig. 2

Overall development of degenerative osteoarthritis after a total meniscecomy estimated by Kaplan-Meyer survivorship analysis.

Fig. 3

Different pattern of degenerative osteoarthritis according to groups after a total meniscectomy. Discrimination in the rate of arthritic change was observed. ^*Group I medial meniscectomy; Group II lateral meniscectomy; Group III meniscectomy on discoid meniscus; Group IV medial meniscectomy with ACL reconstruction.

Fig. 4

(A) Group II had a tendency to show degenerative change earlier than in Group I after a total meniscectomy (p<0.05, log rank test). (B) The same comparison of Group II with III. Group III had a tendency to show degenerative changes earlier than Group II (p<0.05). (C) Same comparison of Group III with IV. Group IV had a tendency to show degenerative change earlier than Group III (p<0.05).

Table 1

Grouping and Its Characteristic of Patients

^*Group I medial meniscectomy; Group II lateral meniscectomy; Group III meniscectomy on discoid meniscus; Group IV medial meniscectomy with ACL reconstruction.

Table 2

Functional outcome according to the Lysholm knee score at the last follow-up

Table 3

Development of Degenerative Osteoarthritis after a Total Meniscectomy

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