Partial versus total meniscectomy. A prospective, randomised study with long-term follow-up.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Knee biomechanics

Background:

• Meniscal lesions are common knee injuries.
• Surgical options include partial or total meniscectomy.
• Long-term outcomes of these procedures require further investigation.

Purpose of the Study:

• To compare the long-term outcomes of partial versus total meniscectomy.
• To evaluate functional scores, patient complaints, instability, and degeneration after meniscectomy.

Main Methods:

• Two hundred patients with meniscal lesions were randomly assigned to partial or total meniscectomy.
• Outcomes were assessed at one year and at a median of 7.8 years post-surgery.
• Data collected included patient complaints, functional scores, knee stability, and radiological signs of degeneration.

Main Results:

• After one year, 90% of partial meniscectomy patients were complaint-free versus 80% of total meniscectomy patients.
• At long-term follow-up, 62% of partial meniscectomy patients and 52% of total meniscectomy patients were complaint-free (p=0.18).
• Partial meniscectomy patients reported higher functional scores; however, functional deterioration rates were similar between groups. Mediolateral instability increased significantly in both groups, more so after total meniscectomy. Radiological degeneration increased similarly in both groups.

Conclusions:

• Partial meniscectomy may offer better short-term relief and higher functional scores compared to total meniscectomy for meniscal lesions.
• Long-term functional outcomes and degeneration rates show no significant difference, but partial meniscectomy is associated with less instability.
• Further research is warranted to optimize surgical techniques and patient selection for meniscal repair.