Artikel
Conversion to arthroplasty is more common after meniscectomy than meniscus repair in patients older than age 40
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Autoren
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Armin Runer
- Sektion Sportortopädie, Klinikum rechts der Isar, TU München, München, Germany
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Emre Anil Özbek
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
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Sahil Dadoo
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
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Laura Keeling
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
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Camila Grandberg
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
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Ian Engler
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
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Jonathan Hughes
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
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James J. Irrgang
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
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Volker Musahl
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, United States
| Veröffentlicht: | 21. Oktober 2024 |
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Gliederung
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Objectives: To describe rates of conversion to unicompartmental or total knee arthroplasty (KA) in patients over the age of 40 years (at initial surgery) after partial meniscectomy (ME) or meniscal repair (MR).
Methods: Patients over the age of 40 undergoing isolated ME or MR between 2016 and 2018 were extracted from a single healthcare provider database. Data on patient characteristics, type of initial surgery, number of returns to the operating room as well as performed procedures, including conversion to KA, were recorded. Comparative group statistics as well as a Kaplan-Meier survival rate analysis were performed.
Results and conclusion: A total of 3,638 patients (47.8% female) were included, with 3520 (96.8%) undergoing ME and 118 (3.2%) MR. Overall, 378 (10.4%) patients returned to the OR at an average of 22.7±17.3 months postoperatively. Conversion to KA was performed more frequently in patients after primary ME (n=270, 7.7%) compared to those with MR (2.5%, n=3, OR: 3.2, p=.03). Compared to ME (2.3%, n=82), twice as many patients undergoing MR returned for subsequent meniscus surgery (MR: 5.9%, n = 7, OR: 2.6, p=.02,). Time from primary surgery to KA (ME: 22±17 months, MR: 25±15 months, p= .96) did not differ between the treatment groups. Survivorship was 95% for ME and 98.2% for MR after 24 months (p=0.76) and 92.5% and 98.2% after 60 months (p=0.07), respectively (Figure 1 [Fig. 1]).
The overall reoperation rate after meniscal surgery was 10.4% in patients over the age of 40 years. Patients treated with primary meniscectomy have over three times higher odds to undergo subsequent knee arthroplasty compared to those treated with meniscal repair. However, patients with primary meniscal repair have a higher rate of subsequent meniscus surgery compared to those undergoing primary meniscectomy. This information is important when considering and treating a patient over the age of 40 and meniscal injury.
