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Updated: Sep 2, 2025
Destabilization of the Medial Meniscus and Cartilage Scratch Murine Model of Accelerated Osteoarthritis
Published on: July 6, 2022
Age alone does not affect the joint survivorship after arthroscopic partial meniscectomy for degenerative medial
Ju-Ho Song1, Seong-Il Bin2, Jong-Min Kim3
1Department of Orthopedic Surgery, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Republic of Korea.
Purpose:
To evaluate the effect of age itself on the joint survivorship after arthroscopic partial meniscectomy (APM) for degenerative medial meniscus tears (DMTs).
Methods:
Patients undergoing APM for DMTs during 1999-2010 were retrospectively reviewed. The inclusion criteria were as follows: (1) DMTs identified on preoperative MRI scans, (2) no definite history of trauma, and (3) follow-up duration more than 5 years. In evaluation of the joint survivorship, the endpoint was defined as conversion to arthroplasty (or realignment osteotomy) or progression to Kellgren-Lawrence grade 4. The study population was divided into older and younger groups by a cutoff age at which the difference in the joint survival rates was maximized, using a time-dependent receiver operating characteristic (ROC) curve. The two groups were then matched based on propensity scores. The joint survival rates were compared between the groups using Kaplan-Meier analysis, before and after propensity score matching (PSM).
Results:
A total of 633 knees were included. The cutoff age was calculated as 60 years. Before PSM, 239 knees were allocated to the older group (≥ 60 years) and 394 knees to the younger group (< 60 years). A significant difference in the joint survival rates was noted between the groups (log-rank test, p < 0.001). After PSM, 183 knees remained in each group. The difference in the survival rates was no more statistically significant (n.s.). The latest Lysholm scores of the older and the younger groups before PSM were 72.2 ± 20.8 and 79.9 ± 19.6, respectively (p < 0.001); however, the scores after PSM were 73.2 ± 20.3 and 77.4 ± 20.5, respectively (n.s.).
Conclusions:
Joint survivorship after APM was affected by other factors associated with the aging process, such as cartilage status and meniscal tear pattern, rather than age itself. Advanced age should not be the only reason for precluding APM in treatment of DMTs. APM is a viable option when treating DMTs in elderly patients if adopted with caution. According to this study, a surgeon should assess the age-related factors when he considers APM in elderly patients.
Level Of Evidence:
III.
Insights
Age itself does not significantly impact joint survival after arthroscopic partial meniscectomy (APM) for degenerative medial meniscus tears (DMTs). Other age-related factors, not chronological age, influence outcomes, suggesting APM is a viable option for elderly patients.
Area of Science:
- Orthopedics
- Sports Medicine
- Biomedical Engineering
Background:
- Degenerative medial meniscus tears (DMTs) are common, often treated with arthroscopic partial meniscectomy (APM).
- The influence of patient age on long-term joint survivorship after APM for DMTs remains a critical clinical question.
- Understanding age-related factors is crucial for optimizing treatment decisions in an aging population.
Purpose of the Study:
- To determine if chronological age itself, independent of other factors, affects joint survivorship following APM for DMTs.
- To identify a potential age cutoff for differentiating outcomes in patients undergoing APM for DMTs.
- To compare joint survival rates between older and younger patient groups before and after propensity score matching.
Main Methods:
- Retrospective review of 633 patients undergoing APM for DMTs between 1999-2010 with >5 years follow-up.
- Joint survivorship endpoint defined as conversion to arthroplasty or Kellgren-Lawrence grade 4.
- Time-dependent ROC curve analysis to establish an age cutoff (60 years), followed by propensity score matching (PSM) for group comparison using Kaplan-Meier analysis.
Main Results:
- A significant difference in joint survival rates was observed between older (≥60 years) and younger (<60 years) groups before PSM (p<0.001).
- After PSM, no statistically significant difference in joint survival rates was found between the matched groups (183 knees per group).
- Lysholm scores also showed no significant difference after PSM, although they were significantly higher in the younger group before matching.
Conclusions:
- Joint survivorship after APM for DMTs is influenced by age-related factors like cartilage status and tear patterns, not solely by chronological age.
- Advanced age alone should not be a contraindication for APM in patients with DMTs.
- APM is a feasible treatment for elderly patients with DMTs, provided a comprehensive assessment of age-related factors is performed.
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