The purpose of this study was radiologic assessment of osteoarthritis after arthroscopic partial meniscectomy. At an average followup of 53.5 months, 284 consecutive patients were retrospectively evaluated clinically and radiologically. Two hundred forty-seven patients had been treated for medial (Group I) and 37 for lateral meniscal tears (Group II). Preoperative radiographs were compared with those at followup and were classified. The results were analyzed statistically. Osteoarthritic changes were classified as being worse in 38% of the patients after medial and in 24% of the patients after lateral arthroscopic partial meniscectomy. Further subclassification and comparison of patients with or without already existing articular surface damage at the time of arthroscopy were not found to have significant impact on the prevention of osteoarthritic changes. Patients who were older than 40 years of age and who had undergone arthroscopic partial medial meniscectomy were radiologically classified with a significantly higher rate of osteoarthritis than patients who were younger than 40 years. Partial medial or lateral meniscectomy leads to a significant increase of osteoarthritic changes, even when this intervention is performed arthroscopically.
The purpose of this study was to evaluate the long-term clinical outcome of operative versus nonoperative treatment of anterior cruciate ligament (ACL) deficiency and to define its relationship with sports activity. Forty-six patients (37 male, 9 female, mean age, 33.6 +/- 8.0 years) who underwent open ACL reconstruction using patellar tendon autograft and 25 patients (18 male, 7 female, mean age, 32.3 +/- 9.9 years) who were treated nonoperatively were evaluated by the same two examiners at 5 - 7 and 10 - 13 years following injury. The evaluations included objective and subjective scoring (Lysholm, OAK, IKDC), instrumented testing (Cybex, KT 1000), radiographic evaluation, and assessments of sports activity, with respect to type, frequency and associated symptoms. According to Lysholm, OAK and IKDC scores, the operative group performed significantly (p < 0.05) better and was able to maintain increased involvement in sports, although both groups participated less over time. However, risks for degenerative joint changes were similar for both the operative and the nonoperative group. A significant (p < 0.05) correlation between participation in high-risk pivoting sports, such as soccer or basketball and osteoarthritic changes could be found for the nonoperative group, only. Sports activity represents an important variable not only affecting the outcome, but also influencing treatment decisions following ACL injuries.
Accurate definition of the insertion sites of the PCL is essential for anatomic double-bundle reconstruction. The results of our study may be used as a reference for intraoperative and postoperative assessments of correct femoral and tibial tunnel placements.
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