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Retaining more meniscal tissue yields better function, less swelling 2 years after meniscectomy
Study indicates amount of meniscal tissue removed correlates with symptoms, indirectly supporting meniscal repair.
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FLORENCE — The amount of meniscal tissue removed during meniscectomy corresponds to key post-meniscectomy clinical knee symptoms, according to results of a prospective study presented here.
Researchers found a significant correlation between the percentage of meniscus remaining after surgery and the domains of squatting, stair climbing and swelling, said William G. Rodkey, DVM, of Vail, Colo., at the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress.
The study involved 149 patients aged 18 to 60 years who served as control subjects in another trial. These patients had undergone partial meniscectomies as part of that larger study. The researchers categorized 81 patients as acute cases, without prior meniscus surgery, and 68 patients as chronic cases, having had one to three prior partial meniscectomies, Rodkey said.
Investigators hypothesized that patients with more than 50% of their meniscus removed would suffer some disability, he said.
For each patient, investigators used special instruments to calculate the amount of remaining meniscus as a percent of original tissue. They then followed the patients clinically for 2 years, minimum, with 127 of 149 patients available at final follow-up.
Outcome measures used included the Lysholm function and Tegner activity scores. Investigators also calculated the Tegner index, or the percent of lost activity that was regained postoperatively.
Investigators found that the amount of remaining meniscal tissue significantly correlated with the Lysholm squatting, stair climbing and knee swelling domains, according to the study abstract.
"In particular, patients who had [more than] 50% of their meniscus remaining had significantly better function than patients who had [less than] 50% [of their] meniscus remaining," the authors wrote.
The Tegner index indicated that patients who improved scored about 52% vs. 24% for patients whose pain worsened or was unchanged at follow-up (P=.017), according to the study.
For more information:
- William G. Rodkey, DVM, receives research support, miscellaneous non-income support, stock/stock options from and is a consultant to ReGen Biologics.
- Rodkey WG, Briggs KK, Steadman JR. Clinical symptoms, function and activity levels correlate with degree of tissue loss following meniscectomy. #254. Presented at the 2007 International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress. May 27-31, 2007. Florence.