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Patient-relevant outcomes fourteen years after meniscectomy : influence of type of meniscal tear and size of resection

Englund, M LU ; Roos, E M LU ; Roos, H P LU and Lohmander, L S LU (2001) In Rheumatology1999-01-01+01:00 40(6). p.631-639
Abstract

OBJECTIVES: To study long-term patient-relevant outcomes after meniscectomy, a surgical procedure associated with a high risk of knee osteoarthritis (OA). Principal objectives were to compare traumatic with degenerative meniscal tear and partial with subtotal meniscectomy.

METHODS: We studied a well-defined cohort of 205 patients who had undergone isolated unilateral meniscectomy between 1983 and 1985. There was no previous knee surgery and all knees were stable. The type of meniscal tear and surgical resection was ascertained by review of medical records. Patients were followed up after 14 yr (range 12-15 yr) by self-administered questionnaires, one generic [Short Form 36 (SF-36)] and one disease-specific [Knee Injury and... (More)

OBJECTIVES: To study long-term patient-relevant outcomes after meniscectomy, a surgical procedure associated with a high risk of knee osteoarthritis (OA). Principal objectives were to compare traumatic with degenerative meniscal tear and partial with subtotal meniscectomy.

METHODS: We studied a well-defined cohort of 205 patients who had undergone isolated unilateral meniscectomy between 1983 and 1985. There was no previous knee surgery and all knees were stable. The type of meniscal tear and surgical resection was ascertained by review of medical records. Patients were followed up after 14 yr (range 12-15 yr) by self-administered questionnaires, one generic [Short Form 36 (SF-36)] and one disease-specific [Knee Injury and Osteoarthritis Outcome Score (KOOS)].

RESULTS: In a multivariate analysis, using the Sports and Recreation Function and knee-related Quality of Life subscales of the KOOS questionnaire as dependent variables, patients with a degenerative tear scored significantly worse than individuals with a traumatic tear (P < or = 0.001). When we analysed unmatched subgroups and age- and sex-matched patients with degenerative or traumatic lesions, the same result was found for the knee-specific outcome (P < or = 0.02) and SF-36 except for Social Functioning (P < or = 0.04). There was no difference in outcome for the total cohort according to the type of resection. However, subgroup analyses showed that patients who underwent subtotal meniscectomy for a degenerative tear scored significantly worse on the knee-specific outcome than individuals who had had a partial meniscectomy for the same type of tear (P < or = 0.02).

CONCLUSIONS: The long-term outcome of meniscal injury and surgery appears to be determined largely by the type of meniscal tear. Furthermore, our findings support the use of minimal meniscal resection in the treatment of degenerative tears. We suggest that the disease processes associated with the development of OA of the joint cartilage may also be active in the meniscus, and that a tear in a meniscus with degenerative changes might be regarded as the first sign of OA of the joint.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult, Cohort Studies, Humans, Menisci, Tibial, Middle Aged, Multivariate Analysis, Outcome Assessment (Health Care)
in
Rheumatology1999-01-01+01:00
volume
40
issue
6
pages
9 pages
publisher
Oxford University Press
external identifiers
  • wos:000169705000006
  • scopus:0034930642
ISSN
1462-0332
DOI
10.1093/rheumatology/40.6.631
language
English
LU publication?
yes
id
b8ab76b7-c5f9-4461-b936-4031d66000a2 (old id 131758)
alternative location
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11426019&ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
date added to LUP
2007-07-03 11:34:47
date last changed
2018-08-05 04:02:51
@article{b8ab76b7-c5f9-4461-b936-4031d66000a2,
  abstract     = {<p>OBJECTIVES: To study long-term patient-relevant outcomes after meniscectomy, a surgical procedure associated with a high risk of knee osteoarthritis (OA). Principal objectives were to compare traumatic with degenerative meniscal tear and partial with subtotal meniscectomy.</p><p>METHODS: We studied a well-defined cohort of 205 patients who had undergone isolated unilateral meniscectomy between 1983 and 1985. There was no previous knee surgery and all knees were stable. The type of meniscal tear and surgical resection was ascertained by review of medical records. Patients were followed up after 14 yr (range 12-15 yr) by self-administered questionnaires, one generic [Short Form 36 (SF-36)] and one disease-specific [Knee Injury and Osteoarthritis Outcome Score (KOOS)].</p><p>RESULTS: In a multivariate analysis, using the Sports and Recreation Function and knee-related Quality of Life subscales of the KOOS questionnaire as dependent variables, patients with a degenerative tear scored significantly worse than individuals with a traumatic tear (P &lt; or = 0.001). When we analysed unmatched subgroups and age- and sex-matched patients with degenerative or traumatic lesions, the same result was found for the knee-specific outcome (P &lt; or = 0.02) and SF-36 except for Social Functioning (P &lt; or = 0.04). There was no difference in outcome for the total cohort according to the type of resection. However, subgroup analyses showed that patients who underwent subtotal meniscectomy for a degenerative tear scored significantly worse on the knee-specific outcome than individuals who had had a partial meniscectomy for the same type of tear (P &lt; or = 0.02).</p><p>CONCLUSIONS: The long-term outcome of meniscal injury and surgery appears to be determined largely by the type of meniscal tear. Furthermore, our findings support the use of minimal meniscal resection in the treatment of degenerative tears. We suggest that the disease processes associated with the development of OA of the joint cartilage may also be active in the meniscus, and that a tear in a meniscus with degenerative changes might be regarded as the first sign of OA of the joint.</p>},
  author       = {Englund, M and Roos, E M and Roos, H P and Lohmander, L S},
  issn         = {1462-0332},
  keyword      = {Adult,Cohort Studies,Humans,Menisci, Tibial,Middle Aged,Multivariate Analysis,Outcome Assessment (Health Care)},
  language     = {eng},
  number       = {6},
  pages        = {631--639},
  publisher    = {Oxford University Press},
  series       = {Rheumatology1999-01-01+01:00},
  title        = {Patient-relevant outcomes fourteen years after meniscectomy : influence of type of meniscal tear and size of resection},
  url          = {http://dx.doi.org/10.1093/rheumatology/40.6.631},
  volume       = {40},
  year         = {2001},
}