School of Medicine, University of Turin, Turin, Italy.
Villa Maria Pia Hospital, Turin, Italy.
Knee. 2021 Mar;29:49-54. doi: 10.1016/j.knee.2021.01.007. Epub 2021 Feb 5.
To define arthroscopic meniscectomy (AM) outcomes in young patients at 20 years follow up in terms of predictors of poor clinical results, rate and timing of conversion to total knee replacement (TKR).
The following data were collected for 225 patients aged between 18 and 50 years with meniscal tear (MT) who underwent AM: age at surgery, gender, injured meniscus, knee alignment, associated lesions, amount of meniscal resection. At 20 years follow up, rate and timing of TKR conversion and clinical outcomes with Knee injury and Osteoarthritis Outcome Score (KOOS) score were reviewed.
Ten patients (4.4%) required TKR in the follow up period. The mean time from AM to TKR was 7.0 years (standard deviation 3.87). Age between 40 and 50 years at AM (P < 0.01), malalignment (P < 0.01), lateral meniscectomy (any size, P = 0.01), advanced chondral lesion (Outerbridge > 2, P < 0.01) and total meniscectomy (P < 0.01) were significantly related to subsequent TKR. Negative predicting factors to obtaining equal or superior to age/sex-adjusted KOOS score were age between 40 and 50 years old at time of AM (P < 0.01), female sex (P < 0.01), malalignment (P = 0.04), and advanced chondral lesion (Outerbridge > 2, P = 0.02).
Twenty years conversion rate to TKR after AM for MT is 4.4% and TKR was performed after a mean time of 7 years. Significant association between TKR surgery and advanced chondral lesion (Outerbridge > 2), total meniscectomy, lateral meniscectomy, age at surgery between 40 and 50 years old, and malalignment were found. Age between 40 and 50 years at time of AM, female, malalignment, advanced chondral lesion were all factors significantly related to poor clinical results.
在 20 年的随访中，确定年轻患者（18-50 岁）接受关节镜半月板切除术（AM）的结局，包括预测临床结果不良的因素、全膝关节置换术（TKR）的发生率和时间。
对 225 例半月板撕裂（MT）行 AM 的患者收集以下数据：手术年龄、性别、损伤的半月板、膝关节对线、合并损伤、半月板切除量。在 20 年的随访中，评估 TKR 转换的发生率和时间以及 Knee injury and Osteoarthritis Outcome Score（KOOS）评分的临床结果。
在随访期间，10 例（4.4%）患者需要 TKR。从 AM 到 TKR 的平均时间为 7.0 年（标准差 3.87）。AM 时年龄在 40-50 岁（P<0.01）、对线不良（P<0.01）、外侧半月板切除术（任何大小，P=0.01）、进展性软骨损伤（Outerbridge>2，P<0.01）和全半月板切除术（P<0.01）与随后的 TKR 显著相关。获得与年龄/性别调整后的 KOOS 评分相等或更高的评分的阴性预测因素为 AM 时年龄在 40-50 岁（P<0.01）、女性（P<0.01）、对线不良（P=0.04）和进展性软骨损伤（Outerbridge>2，P=0.02）。
MT 行 AM 后 20 年的 TKR 转化率为 4.4%，TKR 的平均时间为 7 年。TKR 手术与进展性软骨损伤（Outerbridge>2）、全半月板切除术、外侧半月板切除术、AM 时年龄在 40-50 岁之间以及对线不良之间存在显著相关性。AM 时年龄在 40-50 岁之间、女性、对线不良、进展性软骨损伤均与临床结果不良显著相关。
