Purpose
To report the arthroscopic treatment results of a degenerative medial meniscus tear
with a displaced flap into the meniscotibial recess, tibial peripheral reactive bone
edema, and focal knee medial pain. As a secondary objective, we propose to identify
possible factors associated with a good or poor prognosis of the surgical treatment
of this lesion.
Methods
From 2012 to 2018, patients who had this specific meniscus pathology and underwent
arthroscopic surgical treatment were retrospectively evaluated. Patients with Kellgren-Lawrence
(KL) classification greater than 2 were excluded. KL classification, the presence
of an Outerbridge grade III/V chondral lesion of the medial compartment, limb alignment,
body mass index, and smoking were evaluated. The subjective outcomes included the
International Knee Documentation Committee score, improvement in the pain reported
by patients, and the Global Perceived Effect (GPE) scale score.
Results
A total of 69 patients were evaluated. The mean age was 58.6 ± 7.1 years. The follow-up
time was 48.7 ± 20.8 months. Fifty-five (79.7%) patients reported pain improvement.
The postoperative International Knee Documentation Committee was 62.6 ± 15.4, and
the mean GPE was 2.3 ± 2.6. Fourteen patients (20.3%) showed no improvement in pain,
and 7 patients (10.2%) presented complications. Groups that improved (GPE > 0) and
did not improve (GPE < 0) did not present differences regarding age, sex, follow-up
time, chondral lesions, or body mass index. Patients without improvement had a greater
incidence of smoking (P = .001), varus alignment (P = .008), and more advanced KL classification (P < .001). In the multivariate analysis based on the GPE score, KL classification (P = .038) and smoking (P = .003) were significant.
Conclusions
Arthroscopic surgical treatment of degenerative medial meniscal tears with a meniscal
flap displaced into the meniscotibial recess and adjacent focal bone edema in the
tibia shows good results in approximately 80% of cases. Smoking and KL grade 2 were
factors associated with poor prognosis of surgical treatment.
Level of Evidence
Level IV (case series).
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Article info
Publication history
Published online: April 29, 2021
Accepted:
April 15,
2021
Received:
September 25,
2020
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
