Coronal Knee Alignment 40 Years after Total Meniscectomy in Adolescents: A Prospective Cohort Study

Area of Science:

• Orthopedic surgery
• Biomechanical analysis
• Radiographic assessment

Background:

• Meniscectomies alter knee biomechanics, increasing joint contact forces.
• Long-term consequences of adolescent meniscectomies on knee alignment and joint health are not fully understood.

Purpose of the Study:

• To assess coronal knee alignment 40 years after total open meniscectomies in adolescence.
• To correlate alignment with osteoarthritis, range of motion, and patient-reported outcomes.

Main Methods:

• Standardized weight-bearing radiographs analyzed for tibiofemoral angle and malalignment magnitude.
• Correlations assessed between meniscectomy site, radiographic osteoarthritis (Ahlback, Kellgren & Laurence), range of motion, and patient-reported outcomes (IKDC, KOOS).

Main Results:

• Medial meniscectomy led to significantly more varus alignment and higher malalignment magnitude.
• Reduced range of flexion observed after medial and/or lateral meniscectomy.
• Worse IKDC and KOOS quality of life scores in patients with bilateral meniscectomies.
• Tibiofemoral angle, malalignment, and range of flexion strongly correlated with radiographic osteoarthritis scores, but not patient-reported outcomes.

Conclusions:

• Meniscectomy-induced malalignment is site-specific and correlates with radiographic osteoarthritis.
• Malalignment and reduced range of motion predict radiographic arthritis progression.
• Patient-reported outcomes do not correlate with radiographic findings or malalignment in this long-term follow-up.