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[Meniscus replacement with quadriceps tendon--a long-term analysis]
T Pressel1, G V Lewinski, D Kohn
1Orthopädische Klinik der MHH im Annastift e. V., Hannover. pressel@annastift.de
Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|March 9, 2005
Summary
Meniscus replacement using quadriceps tendon after complete meniscectomy did not improve outcomes compared to standard meniscectomy, showing inferior subjective results to meniscal allografts. This procedure is not generally recommended for knee osteoarthritis prevention.
Area of Science:
- Orthopedic surgery
- Sports medicine
- Regenerative medicine
Background:
- Complete meniscectomy often leads to early knee osteoarthritis.
- Autogenous quadriceps tendon grafts were used for meniscus replacement to prevent degenerative changes.
- Simultaneous anterior cruciate ligament reconstruction was performed in a subset of patients.
Purpose of the Study:
- To evaluate the subjective, clinical, and radiological outcomes of meniscus replacement with quadriceps tendon.
- To compare these outcomes with those of simple meniscectomy and meniscal allografts.
- To determine the efficacy of this procedure in preventing knee osteoarthritis after meniscectomy.
Main Methods:
- Standardized patient examinations including KOOS questionnaire and IKDC form.
- Weight-bearing radiography of the knee.
- Follow-up period ranged from 4 to 17 years postoperatively (average 9 years).
Main Results:
- Fair subjective results for symptoms, but poor results for sports and quality of life.
- Clinically stable knees without effusion, but significant osteoarthritis observed radiologically.
- Outcomes were comparable to simple meniscectomy and inferior to meniscal allografts in subjective measures.
Conclusions:
- Meniscus replacement with quadriceps tendon showed no advantage over standard meniscectomy in patients with pre-existing chondromalacia and anterior instability.
- The procedure cannot be generally recommended for preventing degenerative changes after meniscectomy.
- Degenerative changes were observed even after meniscal allograft transplantation.