Total meniscectomy in adolescents

A 40-year follow-up

I. P. Pengas, A. Assiotis, W. Nash, J. Hatcher, J. Banks, M. J. McNicholas

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Abstract

We continued a prospective longitudinal follow-up study of 53 remaining patients who underwent open total meniscectomy as adolescents and who at that time had no other intra-articular pathology of the knee. Their clinical, radiological and patient-reported outcomes are described at a mean follow-up of 40 years (33 to 50). The cohort of patients who had undergone radiological evaluation previously after 30 years were invited for clinical examination, radiological evaluation and review using two patient-reported outcome measures.

A total of seven patients (13.2%) had already undergone total knee replacement at the time of follow-up. A significant difference was observed between the operated and non-operated knee in terms of range of movement and osteoarthritis of the tibiofemoral joint, indicating a greater than fourfold relative risk of osteoarthritis at 40 years post-operatively. All patients were symptomatic as defined by the Knee Injury and Osteoarthritis Outcome Score.

This study represents the longest follow-up to date and it can be concluded that meniscectomy leads to symptomatic osteoarthritis of the knee later in life, with a resultant 132-fold increase in the rate of total knee replacement in comparison to their geographical and age-matched peers.

Footnotes

  • The authors would like to thank the Warrington Hospital Charitable fund for covering the expenses incurred during the study.

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

  • Received July 29, 2012.
  • Accepted September 4, 2012.
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