Total Knee Arthroplasty After Meniscectomy Is More Likely in Patients With Bicompartmental or Complex Tears.
| Autor: | Berlinberg EJ; Midwest Orthopedics at Rush, Chicago, Illinois, U.S.A.; NYU Grossman School of Medicine, New York, New York, U.S.A., Song M; NYU Grossman School of Medicine, New York, New York, U.S.A., Sivasundaram L; Midwest Orthopedics at Rush, Chicago, Illinois, U.S.A., Patel HH; Midwest Orthopedics at Rush, Chicago, Illinois, U.S.A., Mascarenhas R; Winnipeg Clinic, Winnipeg, Manitoba, Canada., Forsythe B; Midwest Orthopedics at Rush, Chicago, Illinois, U.S.A. |
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| Jazyk: | angličtina |
| Zdroj: | Arthroscopy, sports medicine, and rehabilitation [Arthrosc Sports Med Rehabil] 2023 Apr 11; Vol. 5 (3), pp. e577-e587. Date of Electronic Publication: 2023 Apr 11 (Print Publication: 2023). |
| DOI: | 10.1016/j.asmr.2023.02.010 |
| Abstrakt: | Purpose: To determine the relationship between meniscus tear morphologies, stratified by location and pattern, and knee arthroplasty rates in a commercial insurance population. Methods: The PearlDiver database was queried for patients ≥35 years old with a meniscus tear of specified laterality and ≥2 years follow-up between 2015 and 2018. Two analyses were conducted with cohorts matched on age, sex, Charlson Comorbidity Index, obesity, osteoarthritis (OA), and treatment (meniscectomy vs conservative): one with equal-sized subgroups by tear location (medial only, lateral only, or both medial and lateral) and another by tear pattern (bucket-handle, complex, or peripheral). The rate of subsequent total knee arthroplasty (TKA) was compared between matched groups. Results: In total, 129,987 patients (mean age: 57.8 ± 10.5 years) were matched by tear location; 1,734 patients with medial-only tears (4.0%), 1,786 with lateral-only tears (4.1%), and 2,611 with medial plus lateral tears (6.0%) underwent a TKA within 5 years ( P < .001). Patients with both medial and lateral tears were 1.55-fold more likely to undergo TKA. In total, 24,213 patients (mean age: 56.0 ± 10.5 years) were matched by tear pattern; 296 patients with bucket-handle tears (3.7%), 373 with complex tears (4.6%), and 336 with peripheral tears (4.2%) underwent TKA ( P = .01). Patients with complex tears were 1.29-fold more likely to undergo TKA than patients with bucket-handle tears ( P = .002). Conclusions: In matched cohorts of patients with degenerative meniscus tears, having both medial plus lateral tears conferred a 1.5-fold risk of TKA, whereas complex tears conferred a 1.3-fold risk within 5 years. Specific meniscal tear patterns and locations harbor varying risk in progressing to end-stage knee OA, and these data may help counsel patients about their likelihood of progressing to end-stage OA warranting an arthroplasty procedure. Level of Evidence: Level III, retrospective comparative study. (© 2023 The Authors.) |
| Databáze: | MEDLINE |
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