Does arthroscopic partial meniscectomy result in knee osteoarthritis? A systematic review with a minimum of 8 years' follow-up.

摘要

PURPOSE: Our purpose is to test the hypothesis that arthroscopic partial meniscectomy results in knee osteoarthritis at long-term follow-up. METHODS: We systematically reviewed PubMed search terms "meniscus AND arthritis AND knee" and meniscectomy AND arthritis AND knee IV evidence studies reporting either radiographic or clinical osteoarthritis outcome measures with a minimum of 8 years' follow-up after partial arthroscopic meniscectomy. RESULTS: Five studies met the inclusion criteria. All reported both radiographic and clinical measures. All studies compared the normal, contralateral knee as a radiographic control, but none included a clinical control group. Follow-up ranged from 8 to 16 years. In all studies operative knees showed a statistically significant incidence of radiographic signs of osteoarthritis compared with control knees. However, clinical symptoms of osteoarthritis were not observed. Furthermore, clinical outcomes did not correlate with radiographic findings. DISCUSSION: Our results show that radiographic signs of osteoarthritis are significant at 8 to 16 years' follow-up after knee arthroscopic partial meniscectomy, but clinical symptoms of knee arthritis were not observed. Limitations include absence of clinical control groups and heterogeneity of reported outcome measures. Future research of higher levels of evidence and with longer-term follow-up is required to determine whether the radiographic signs ultimately foreshadow clinical symptoms in patients after arthroscopic partial meniscectomy. CONCLUSIONS: Radiographic signs of osteoarthritis are significant at 8 to 16 years' follow-up after knee arthroscopic partial meniscectomy, but clinical symptoms of knee arthritis are not significant. LEVEL OF EVIDENCE: Systematic review of Level IV clinical evidence and Levels II and III radiographic evidence.