Outcomes at 20 Years After Meniscectomy in Patients Aged 50 to 70 Years
| Autor: | Luca Barberis, Diego Testa, Angelo Costantino, Alessandro Massè, Luisangelo Sordo, Alessandro Aprato, Luigi Sabatini |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Anterior cruciate ligament reconstruction medicine.medical_treatment Knee Injuries Osteoarthritis Meniscus (anatomy) Lesion 03 medical and health sciences 0302 clinical medicine Humans Medicine Meniscus Orthopedics and Sports Medicine In patient Aged Female Middle Aged Retrospective Studies Survival Analysis Treatment Outcome Meniscectomy 030222 orthopedics medicine.diagnostic_test business.industry Arthroscopy Retrospective cohort study 030229 sport sciences medicine.disease Surgery medicine.anatomical_structure Associated procedure medicine.symptom business |
| Zdroj: | Arthroscopy: The Journal of Arthroscopic & Related Surgery. 37:1547-1553 |
| ISSN: | 0749-8063 |
| DOI: | 10.1016/j.arthro.2020.11.053 |
| Popis: | To report the outcomes of arthroscopic meniscectomy (AM) at 20 years of follow-up through timing/rate of conversion to total knee replacement (TKR) and Knee Injury and Osteoarthritis Outcome Score (KOOS), focusing on detection of specific predictor variables for these outcomes, in patients 50 to 70 years old.We performed a retrospective study of 289 patients, ages at surgery 50 to 70 years, with diagnosis of degenerative meniscal tear who underwent arthroscopic meniscectomy. We collected the following baseline data: age, sex, injured meniscus (medial, lateral, or both), knee alignment, osteoarthritis (OA), associated lesion identified during arthroscopy, and associated procedure performed during arthroscopy. At 20 years of follow-up, we collected rate and timing of TKR conversion, and we evaluated clinical outcomes with KOOS.Female sex (P.01), older age (P.01), lateral meniscectomy (P = .02), malalignment (P = .03), and advanced chondral lesion (P.01) were found to be significantly related to subsequent TKR. No significant correlation was found between amount of resection and subsequent TKR (P = .26). Negative predictor factors to obtain equal or superior to age- and sex-adjusted KOOS scores were age 60 to 70 years at time of AM (P = .03) and lateral meniscectomy (P = .02).We report a 15.7% conversion rate at 20 years from AM to TKR and a mean time between surgeries of 7 years. Subsequent TKR in the 20 years after AM for degenerative meniscus tears were significantly associated with preoperative OA and chondral lesion (Kellgren Lawrence 2; Outerbridge2), lateral meniscectomy, age at surgery, female sex, and malalignment. Furthermore, age60 years, lateral meniscectomy, and concurrent anterior cruciate ligament reconstruction were negative predictors for poor clinical outcomes at 20 years. Therefore, if patients present with negative predictor factors, the AM should not be proposed as second-line treatment, and nonoperative management should be continued until TKR is unavoidable.IV, case series. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|