J Knee Surg 2019; 32(05): 407-413
DOI: 10.1055/s-0038-1646926
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Knee Osteoarthritis after Arthroscopic Partial Meniscectomy: Prevalence and Progression of Radiographic Changes after 5 to 12 Years Compared with Contralateral Knee

Umile Giuseppe Longo
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
Mauro Ciuffreda
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
Vincenzo Candela
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
Giacomo Rizzello
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
Valerio D'Andrea
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
Nicholas Mannering
2   Department of Orthopaedic and Trauma Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Alessandra Berton
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
Giuseppe Salvatore
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
Vincenzo Denaro
1   Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy
› Author Affiliations
Further Information

Publication History

19 October 2017

20 March 2018

Publication Date:
03 May 2018 (online)


The purpose of this study was to study the clinical and radiographic changes in the knee after arthroscopic partial meniscectomy (APM) at a long-term follow-up compared with the contralateral knee. We assessed 57 patients (38 males and 19 females) with pre- and postoperative weight-bearing radiography with a follow-up ranging from 5.1 to 12.1 years (mean: 8.1) to analyze prevalence and progression of knee osteoarthritis (OA) after APM. We stratified patients according to body mass index (BMI), type of lesion (degenerative vs. traumatic), and side of meniscectomy (medial, lateral, and medial plus lateral). Patients were evaluated both clinically with Knee Osteoarthritis Outcome Score (KOOS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and radiographically with the Kellgren and Lawrence (K/L) score. Radiographic OA was defined as K/L grade 2 or worse. The prevalence of knee OA was 62.69% in the tibiofemoral compartment. The progression of knee OA was statistically significant, ranging from 17.2% preoperatively to 65.95% postoperatively (p = 0.001) in the medial compartment and from 17.64% preoperatively to 58.82% postoperatively (p = 0.0324) in the lateral compartment. The progression of knee OA in the patellofemoral compartment ranged from 5.26 to 42.10% (p = 0.001). The OA progression regarding BMI was higher into the obese group than the normal-weight group and greater in the degenerative group than the traumatic one. The mean KOOS was 72.01 and the mean WOMAC was 73.84. The Spearman's test showed a statistical significance between clinical and radiographic results. Patients in the obese, overweight, and degenerative tear group had a greater predisposition to OA in the tibiofemoral and patellofemoral compartments after meniscectomy. The level of evidence is III, retrospective study.

  • References

  • 1 Maffulli N, Longo UG, Campi S, Denaro V. Meniscal tears. Open Access J Sports Med 2010; 1: 45-54
  • 2 Kim S, Bosque J, Meehan JP, Jamali A, Marder R. Increase in outpatient knee arthroscopy in the United States: a comparison of National Surveys of Ambulatory Surgery, 1996 and 2006. J Bone Joint Surg Am 2011; 93 (11) 994-1000
  • 3 Brophy RH, Gray BL, Nunley RM, Barrack RL, Clohisy JC. Total knee arthroplasty after previous knee surgery: expected interval and the effect on patient age. J Bone Joint Surg Am 2014; 96 (10) 801-805
  • 4 Longo UG, Ciuffreda M, D'Andrea V, Mannering N, Locher J, Denaro V. All-polyethylene versus metal-backed tibial component in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2016; ;(May): 21
  • 5 Longo UG, Loppini M, Romeo G, Maffulli N, Denaro V. Histological scoring systems for tissue-engineered, ex vivo and degenerative meniscus. Knee Surg Sports Traumatol Arthrosc 2013; 21 (07) 1569-1576
  • 6 Longo UG, Loppini M, Forriol F, Romeo G, Maffulli N, Denaro V. Advances in meniscal tissue engineering. Stem Cells Int 2012; 2012: 420346
  • 7 Khanna A, Gougoulias N, Longo UG, Maffulli N. Minimally invasive total knee arthroplasty: a systematic review. Orthop Clin North Am 2009; 40 (04) 479-489
  • 8 Badlani JT, Borrero C, Golla S, Harner CD, Irrgang JJ. The effects of meniscus injury on the development of knee osteoarthritis: data from the osteoarthritis initiative. Am J Sports Med 2013; 41 (06) 1238-1244
  • 9 Monk P, Garfjeld Roberts P, Palmer AJ. , et al. The urgent need for evidence in arthroscopic meniscal surgery: a systematic review of the evidence for operative management of meniscal tears. Am J Sports Med 2016; ;(Jul): 18
  • 10 Thorlund JB, Holsgaard-Larsen A, Creaby MW. , et al. Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy: a prospective cohort study. Osteoarthritis Cartilage 2016; 24 (07) 1153-1159
  • 11 Longo UG, Maffulli N, Denaro V. Minimally invasive total knee arthroplasty. N Engl J Med 2009; 361 (06) 633-634
  • 12 Paradowski PT, Lohmander LS, Englund M. Osteoarthritis of the knee after meniscal resection: long term radiographic evaluation of disease progression. Osteoarthritis Cartilage 2016; 24 (05) 794-800
  • 13 Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 2003; 1: 64
  • 14 Vaquero J, Longo UG, Forriol F, Martinelli N, Vethencourt R, Denaro V. Reliability, validity and responsiveness of the Spanish version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in patients with chondral lesion of the knee. Knee Surg Sports Traumatol Arthrosc 2014; 22 (01) 104-108
  • 15 Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15 (12) 1833-1840
  • 16 Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16 (04) 494-502
  • 17 Roos EM, Roos HP, Ekdahl C, Lohmander LS. Knee injury and Osteoarthritis Outcome Score (KOOS)--validation of a Swedish version. Scand J Med Sci Sports 1998; 8 (06) 439-448
  • 18 Bailey O, Gronkowski K, Leach WJ. Effect of body mass index and osteoarthritis on outcomes following arthroscopic meniscectomy: a prospective nationwide study. Knee 2015; 22 (02) 95-99
  • 19 Filardo G, Kon E, Longo UG. , et al. Non-surgical treatments for the management of early osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2016; 24 (06) 1775-1785
  • 20 Monllau JC, Gelber PE, Abat F. , et al. Outcome after partial medial meniscus substitution with the collagen meniscal implant at a minimum of 10 years' follow-up. Arthroscopy 2011; 27 (07) 933-943
  • 21 Longo UG, Loppini M, Trovato U, Rizzello G, Maffulli N, Denaro V. No difference between unicompartmental versus total knee arthroplasty for the management of medial osteoarthritis of the knee in the same patient: a systematic review and pooling data analysis. Br Med Bull 2015; 114 (01) 65-73
  • 22 Felson DT, Zhang Y, Hannan MT. , et al. The incidence and natural history of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 1995; 38 (10) 1500-1505
  • 23 Salata MJ, Gibbs AE, Sekiya JK. A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med 2010; 38 (09) 1907-1916
  • 24 Englund M, Lohmander LS. Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum 2004; 50 (09) 2811-2819
  • 25 Paradowski PT, Englund M, Lohmander LS, Roos EM. The effect of patient characteristics on variability in pain and function over two years in early knee osteoarthritis. Health Qual Life Outcomes 2005; 3: 59
  • 26 Andriacchi TP, Koo S, Scanlan SF. Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee. J Bone Joint Surg Am 2009; 91 (Suppl. 01) 95-101
  • 27 Andriacchi TP, Mündermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng 2004; 32 (03) 447-457
  • 28 Englund M, Paradowski PT, Lohmander LS. Association of radiographic hand osteoarthritis with radiographic knee osteoarthritis after meniscectomy. Arthritis Rheum 2004; 50 (02) 469-475
  • 29 Englund M, Roos EM, Lohmander LS. Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. Arthritis Rheum 2003; 48 (08) 2178-2187
  • 30 Haviv B, Bronak S, Kosashvili Y, Thein R. Arthroscopic meniscectomy of traumatic versus atraumatic tears in middle aged patients: is there a difference?. Arch Orthop Trauma Surg 2016; 136 (09) 1297-1301
  • 31 Matsusue Y, Thomson NL. Arthroscopic partial medial meniscectomy in patients over 40 years old: a 5- to 11-year follow-up study. Arthroscopy 1996; 12 (01) 39-44
  • 32 Koo S, Andriacchi TP. A comparison of the influence of global functional loads vs. local contact anatomy on articular cartilage thickness at the knee. J Biomech 2007; 40 (13) 2961-2966
  • 33 Herwig J, Egner E, Buddecke E. Chemical changes of human knee joint menisci in various stages of degeneration. Ann Rheum Dis 1984; 43 (04) 635-640
  • 34 Chatain F, Adeleine P, Chambat P, Neyret P. ; Société Française d'Arthroscopie. A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 2003; 19 (08) 842-849
  • 35 Burks RT, Metcalf MH, Metcalf RW. Fifteen-year follow-up of arthroscopic partial meniscectomy. Arthroscopy 1997; 13 (06) 673-679
  • 36 Higuchi H, Kimura M, Shirakura K, Terauchi M, Takagishi K. Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res 2000; (377) 161-168
  • 37 Maffulli N, Longo UG, Gougoulias N, Caine D, Denaro V. Sport injuries: a review of outcomes. Br Med Bull 2011; 97: 47-80