Partial Meniscectomy: More Arthritic Changes Result

Luis Bolano, M.D., and associates at the Oklahoma Center for Athletes and the University of Oklahoma wanted to determine the long-term results of arthroscopic partial meniscectomy. They noted that the short-term results of arthroscopic partial meniscectomy had been excellent-to-good in 80 to 95 percent of patients in the already published studies. (9)

What they found surprised them. The patients, many of whom were athletes, were functioning fairly well. Eighty percent experienced satisfactory results, 66 percent maintained their activity levels, but 26 percent decreased their activity levels after the surgery. Despite the apparent success of the surgery, almost all of the patients showed arthritic changes on x-ray. Forty-one percent had advanced arthritis. The authors noted, "The amount of meniscus removed and the type of tear had a significant effect on the radiographic result." (9)

The problem with arthroscopic surgery is that it does not induce the healing of the menisci. The athlete feels better for a while, but the injured tissue remains injured. This causes the arthritic process to start immediately. If left unchecked, the athlete's abilities will decline, symptomatology will increase, and more arthroscopic or orthopedic surgeries will follow. If the athletes want this, then by all means, continue to be scoped. If they want to avoid arthritis, they must see a Prolotherapist and receive Prolotherapy to stimulate the body to heal the menisci and other injured tissue.

The Outlook is not Good for Post-Surgical Athletes

What is the outlook down the road, 12 to 15 years, for people who have had arthroscopic partial meniscectomies? Not good. In a study of 21 patients who had partial meniscectomy, six needed further meniscal surgery and seven required additional knee surgery. Over 50 percent of the meniscectomized knees needed knee surgery by 12 to 15 years down the road. Eighteen of the 21 patients who underwent meniscectomy had arthritis in the knee. The three with no arthritis were, likely, very inactive people. About 50 percent of the knees, however, had advanced arthritis compared to the non-operated knees. This statement by the authors should be of significance to the athletes, "The activity level of the patients in both groups changed...indicating a downward change from active individual sports, such as tennis, squash, or downhill skiing, to less strenuous physical fitness activities such as cycling, hiking, or cross-country skiing." (10)

Other studies have confirmed similar findings. If no cartilage deterioration occurred before meniscus removal, deterioration will occur after the surgery. (11)

Long-term effects of meniscus removal lead to increased contact stresses and subsequent articular cartilage degeneration. (12-15)

1. (Peterson, L. Sports Injuries. Chicago, IL. Year Book Medical Publishers, 1983; pp. 296-299.)
2. Ahmed, A. In vitro measurement of static pressure distribution in synovial joints. Part 1: Tibial surface of the knees. Journal of Biomechanical Engineering. 1983; 105:216-225.
3. Brown, T. In vitro contact stress distributions on the femoral condyles. Journal of Orthopedic Research. 1984; 2:190-199.)
4. Radin, E. Role of the menisci in the distribution of stress in the knee. Clinical Orthopedics. 1984; 185:290-294.
5. Seedom, B. Transmission of the load in the knee joint with special reference to the role of the menisci: Part 1. Eng Med. 1979; 8:220-228.)
6. Cabaud, H. Medial meniscus repairs. American Journal of Sports Medicine. 1981; 9:129-134.) adversely influencing mechanical function.
7. Newman, A. Mechanics of the healed meniscus in a canine model. American Journal of Sports Medicine. 1989; 17:164-175.)
8. Edwards, D. Radiographic changes in the knee after meniscal transplantation. American Journal of Sports Medicine. 1996; 24:222-229.
9. Bolano, L. Isolated arthroscopic partial meniscectomy. American Journal of Sports Medicine. 1993; 21:432-437.
10. Maletius, W. The effect of partial meniscectomy on the long-term prognosis of knees with localized, severe chondral damage. American Journal of Sports Medicine. 1996; 24:258-262.
11. Cox, J. The degenerative effects of partial and total resection of the medial meniscus in dogs' knees. Clinical Orthopedics. 1975; 109:178-183.
12. Allen, P. Later degenerative changes after medial meniscectomy. Journal of Bone and Joint Surgery. 1984; 66B:666-671.
13. Appel, H. Late results after meniscectomy in the knee joint. Acta Orthop Scand (Suppl). 1970, pg. 133.
14.Tapper, E. Late results after meniscectomy. Journal of Bone and Joint Surgery. 1969; 51A:517-526.
15. Veth, R. Clinical significance of knee joint changes after meniscectomy. Clinical Orthopedics. 1985; 198:56-60.

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