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Arthroscopic, open partial, and total meniscectomy. A comparative study.

M D Northmore-Ball, D J Dandy, R W Jackson

    The Journal of Bone and Joint Surgery. British Volume
    |August 1, 1983
    PubMed
    Summary
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    Arthroscopic partial meniscectomy offers superior outcomes compared to open partial or total meniscectomy for knee injuries. This surgical technique leads to better early recovery and long-term symptomatic results.

    Area of Science:

    • Orthopedic Surgery
    • Sports Medicine
    • Knee Arthroscopy

    Background:

    • Meniscectomy is a common surgical procedure for meniscus tears.
    • Different surgical approaches (arthroscopic vs. open) and extents (partial vs. total) exist.
    • Comparative outcome data for these techniques are essential for clinical decision-making.

    Purpose of the Study:

    • To compare the clinical outcomes of three meniscectomy techniques: arthroscopic partial meniscectomy, open partial meniscectomy, and open total meniscectomy.
    • To evaluate early recovery rates and long-term symptomatic results following these procedures.

    Main Methods:

    • A comparative study involving 219 knees undergoing meniscectomy.
    • Patients were divided into three groups: arthroscopic partial meniscectomy (71 knees), open partial meniscectomy (45 knees), and open total meniscectomy (103 knees).

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  • Exclusion criteria included previous surgery, concurrent procedures, ligamentous damage, and severe osteoarthritis. Mean follow-up was 4.3 years. Early recovery was assessed using simple indicators, and long-term results with the Tapper and Hoover scale.

    • Main Results:

    • Arthroscopic partial meniscectomy demonstrated significantly better outcomes across all assessed criteria compared to open partial and open total meniscectomy.
    • A clear hierarchical relationship in results was observed: arthroscopic techniques outperformed open procedures, and partial meniscectomy yielded better results than total meniscectomy.
    • Patients undergoing arthroscopic partial meniscectomy experienced superior early recovery and long-term symptomatic relief.

    Conclusions:

    • Arthroscopic partial meniscectomy is the preferred surgical approach for meniscus tears, offering superior clinical results.
    • The findings support a graded approach, favoring less invasive arthroscopic techniques and partial meniscectomy over open and total procedures, respectively.
    • This study provides evidence-based recommendations for optimizing surgical management of meniscus injuries.