[Selection of arthroscopic surgical methods for meniscus tear in the elderly and evaluation of curative effect].

OBJECTIVE

To evaluate the methods and effects of arthroscopic operation in aged patients with meniscal injury.

METHODS

From January 2014 to June 2018, 86 elderly patients with meniscal injury met the inclusion criteria, including 35 males and 51 females, aged 60 to 76 years old, with an average age of 63.7 years old, 32 patients with definite trauma and 54 without definite trauma. Arthroscopic partial meniscectomy was performed in 75 cases, partial meniscectomy and anterior angle repair in 2 cases, partial meniscectomy and body repair in 2 cases, and partial meniscectomy and repair in 7 cases of horizontal delamination rupture of posterior horn; 28 patients with mild joint degeneration went through drilling decompression of intercond-ylar fossa. Lysholm score and IKDC score were used to evaluate knee joint function and visual analogue scale(VAS) was used to evaluate pain.

RESULTS

All patients were successfully operated under arthroscope. The follow-up period ranged from 6 to 36 months, with an average of 15 months. The Lysholm score of knee joint increased from preoperative 51.26±12.00 to final follow-up 81.20±4.89 points (=22.07, <0.001); IKDC scores increased from preoperative 48.05±10.68 to final follow-up 76.97±6.26(=23.04, <0.001); and the VAS decreased from preoperative 3.37±0.84 to final follow-up 0.57±0.62(=36.27, <0.001). Two patients with non-traumatic degenerative medial meniscus injury with medial osteoarthritis had no significant improvement after 1 year follow-up, so underwent total knee arthroplasty.

CONCLUSIONS

In elderly patients with knee meniscus injury, arthroscopic partial meniscectomy, or partial meniscectomy and repair can achieve satisfying clinical results. If the injuried joint is accompanied with mild degeneration, drilling hole decompression of intercondylar fossa should be performed at the same time.