[Arthroscopy of degenerative lesions of the internal meniscus. Classification and treatment]

In reference to 310 degenerative meniscal lesions (DML), we are proposing to classify these lesions into five types. They must be differentiated from arthrosis to which they are not automatically associated, even if the presence of cartilaginous lesions appears to be an important prognostic factor. Likewise, studies by age groups mix pure traumatic lesions and properly so called DMLs (which, by definition, do not involve a true initial trauma); the role of micro-traumas seems however probable. In reference to 87 type IV lesions, we remind of the difficulty of the radio-clinical diagnosis, insisting on the readily progressive nature of the troubles (49.4 p. cent of the cases), the lack of specificity of the symptoms, dominated by subjective pain (93 p. cent of the cases) and the pain induced by pressure on the medial joint space (70.1 p. cent of the cases). 87 patients underwent a partial meniscectomy. 72 were followed over a period of 32.4 months. In the entire group, the results are good or very good in 83.3 p. cent of the cases. In case of a considerable cartilaginous lesion visualized on arthroscopy (25 out of 87 patients), there are still 73.7 p. cent of good and very good results.