Does Meniscectomy Have Any Advantage Over Conservative Treatment of Degenerative Medial Meniscus Posterior Root Tear?

Abstract

Background: This study aimed to compare the clinical and radiological outcomes of arthroscopic meniscectomy and conservative treatment for degenerative MMPRT.Methods: From January 2007 to December 2014, 146 patients (Meniscectomy group, 90; Conservative group, 56) were evaluated. Clinical outcomes were assessed using the Visual Analog Scale, International Knee Documentation Committee subjective scoring scale, Tegner activity scale, and Lysholm knee scoring scale at the final follow-up. Radiologic outcomes evaluated the progression of osteoarthritis according to the K-L classification. We compared the hip-knee-ankle angle, medial proximal tibial angle, tibial posterior slope angle, and width of medial joint space. After an average follow-up of 6.3 years, the survivorship was analyzed using the Kaplan–Meier method. Results: Although all clinical outcomes had significantly improved in both groups after treatment, the VAS score (p=0.07), IKDC subjective score (p=0.18), Tegner activity scale score (p=0.08), and Lysholm knee score (p=0.53) showed no significant differences between the two groups at the final follow-up. The progression of OA according to the K-L classification, HKAA and width of medial joint space was significantly advanced in the meniscectomy group (p=0.03, 0.04, 0.03, respectively). The 10-year survival rates in the meniscectomy and conservative groups were 87% and 88%, respectively. Conclusions: This study demonstrated that both conservative treatment and meniscectomy provided symptomatic relief. However, it was confirmed that OA progression was more severe in the meniscectomy. We conclude that arthroscopic meniscectomy had no advantage over conservative treatment in terms of clinical outcomes and OA progression.