Risk of total/subtotal meniscectomy for respective medial and lateral meniscus injury: correlation with tear type, duration of complaint, age, gender and ACL rupture in 6034 Asian patients

Abstract

BackgroundTo evaluate the risk factor associated with total or subtotal meniscectomy for respective medial and lateral meniscus injury.MethodsThe data of all the meniscus injured patients undergoing arthroscopy in our institute between January 15th, 2000 and December 31st, 2008 was collected and 6034 patients with 7241 injured menisci met the inclusion criteria. The mean patient age was 33.6 ± 14.9 years and there were 4785 males and 2456 females with 3568 medial and 3673 lateral menisci. The decision tree approach was applied to investigate the correlation of the tear type, the duration of complaint, age, gender, ACL rupture and total/subtotal meniscectomy for respective medial and lateral meniscus.ResultsThe tear type was associated with both medial (χ2 = 70.901, P < 0.001) and lateral (χ2 = 268.019, P < 0.001) total/subtotal meniscectomy. The strongest risk of total/subtotal meniscectomy of both medial and lateral meniscus tear was shown for the complex tear followed by the longitudinal, oblique, horizontal and radial tear of the medial meniscus and followed by horizontal, longitudinal, radial and oblique tear of the lateral meniscus. The risk of total/subtotal medial meniscectomy was significantly elevated for the patients with complex tear and the age of ≤40 years old (χ2 = 21.028, P < 0.001) and those with the oblique, horizontal or radial tear accompanied by ACL rupture (χ2 = 6.631, P = 0.01). Besides, the duration of complaint was also associated with total/subtotal meniscectomy of the medial longitudinal tear with ACL rupture (χ2 = 17.155, P < 0.001). On the other side, the risk of total/subtotal lateral meniscectomy was significantly elevated for the complex tear of the female patients (χ2 = 5.877, P = 0.015) with no ACL rupture (χ2 = 50.501, P < 0.001). The ACL rupture was associated with a decreased risk of total/subtotal meniscectomy for all the types of the lateral meniscus (complex: χ2 = 50.501, P < 0.001; horizontal: χ2 = 20.897, P < 0.001; oblique: χ2 = 27.413, P < 0.001; longitudinal and radial: χ2 = 110.85, P < 0.001).ConclusionAnalyzing data from a big sample available in an Asian patient database, we found different risk factors associated with total/subtotal meniscectomy for respective medial and lateral meniscus. Identifying patients at high risk for total/subtotal meniscectomy may allow for interventions after meniscus injury.

Tibiofemoral Contact Mechanics With Horizontal Cleavage Tears and Treatment of the Lateral Meniscus in the Human Knee: An In Vitro Cadaver Study

“…However, these studies almost exclusively focused on tears that disrupt the circumferential fibers of the meniscus. Horizontal cleavage tears of the meniscus are most common in the medial meniscus, but also occur in the lateral meniscus [11,26,32,35]. Horizontal cleavage tears in either compartment can cause symptomatic meniscal cysts [13,18,25,42].…”

Submeniscal Portal for Horizontal Cleavage Tear with Parameniscal Cyst of the Lateral Meniscus

“…Since these tears are not amendable to repair, the treatment of choice is either a partial meniscectomy or subtotal meniscectomy. 1 , 2 Goals of a meniscectomy are to remove unstable fragments, smooth any sudden contour changes of the meniscus rim, and to leave as much healthy meniscus as possible. 1 , 2 To achieve these goals, the surgeon needs easy access to the tear site.…”

“…Although our proposed technique has advantages, there are also risks involved, as stated in Table 1 ; however, we do not consider these risks as more significant than standard arthroscopy. 1 , 2 , 3 , 8 , 9 …”

“…The standard anteromedial and anterolateral portals are the mainstay portals of knee arthroscopy; however, inappropriate instrument trajectory through these portals can lead to articular cartilage damage. 1 , 2 Accessing tears of the anterior horn of the lateral meniscus or the inferior leaflet of the meniscus can prove difficult from the anteromedial portal. 1 , 3 The purpose of this Technical Note is to describe an arthroscopic portal that allows easier access and improved debridement of difficult or complex tears of the medial and lateral meniscus.…”

Características Morfométricas de los Discos Articulares de la Rodilla en Imágenes de Resonancia Magnética de Mujeres Colombianas

“…El objetivo del presente trabajo fue realizar una caracterización morfométrica de los DAR de mujeres colombianas sanas a partir de imágenes de RM. Esta caracterización aportará variables cuantitativas útiles para el diseño de MEF que permitirá predecir en la población colombiana el riesgo individual de desarrollar patologías en los DAR, como sucede en la osteoartrosis que se presenta en mayor prevalencia en mujeres (Jiang et al, 2017;Kontio et al, 2017;Sun et al, 2019).…”