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Resection of degenerate menisci - is it useful?
Abstract:
Forty-three symptomatic patients, with a pre-operative MRI diagnosis of an isolated degenerate tear of the meniscus, treated by Arthroscopic resection were reviewed after a minimum follow up of 6 years post-surgery. Pre-operatively there was no clinical or radiological evidence of arthroses, but at surgery 65% of patients were noted to have varying degrees of articular cartilage changes, ranging from Grade I to Grade III according to Outerbridge's classification. Six and a half years (range 6-8 years) following Arthroscopic resection of these degenerate tears 50% of the patients had moderate to severe pain in the operated knee. Their mean Lysholm score was 61.9 (range 11-100, S.D. 27.3) and the median current Tegner activity score was 3 (range 0-7, S.D. 1.65) with 86% patients having dropped their levels of activities by two grades (1-7) (P=0.0001). The SF-36 questionnaire revealed a significant difference in the mean scores for Role Physical, Role Emotional, Mental Health, Vitality and Bodily Pain categories when compared with the mean scores of the general population of similar age and sex range. This suggests that the differences arose due to knee symptoms as there was no significant difference in the mean General Health Scores for the two populations. We conclude that although Arthroscopic resection of these lesions may provide relief in the short-term, these benefits are not long lasting.
Insights
Arthroscopic resection of degenerate meniscus tears offers short-term relief but long-term benefits are limited. Many patients experience persistent knee pain and reduced activity levels years after surgery.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Knee Arthroscopy
Background:
- Degenerate meniscus tears are common in symptomatic patients.
- Arthroscopic resection is a frequent treatment for these tears.
Purpose of the Study:
- To evaluate the long-term outcomes of arthroscopic resection for isolated degenerate meniscus tears.
- To assess persistent pain, functional scores, and activity levels post-surgery.
Main Methods:
- Retrospective review of 43 symptomatic patients with MRI-diagnosed isolated degenerate meniscus tears.
- Follow-up at a minimum of 6 years post-arthroscopic resection.
- Assessment using Lysholm score, Tegner activity score, and SF-36 questionnaire.
Main Results:
- 65% of patients had articular cartilage changes at surgery.
- 50% reported moderate to severe knee pain at 6.5-year follow-up.
- 86% experienced a significant decrease in activity levels (P=0.0001).
- SF-36 scores showed significant differences in physical and mental health domains compared to the general population.
Conclusions:
- Arthroscopic resection of degenerate meniscus tears may not provide lasting benefits.
- Patients often experience long-term pain and functional decline.
- Further research into alternative or adjunctive treatments is warranted.
