title: Painful medial knee compartment syndrome in over-45 year-olds: I--medical or surgical management: a series of 174 patients.
abstract: BACKGROUND
  There is at present no consensus on the management of degenerative medial meniscus lesions in patients aged over 45 years without proven osteoarthritis, especially given that the causal relation between degenerative meniscal lesion and osteoarthritis remains controversial. A prospective multicenter non randomized study was therefore performed. The principal objective was to assess surgeons' practice in the management of degenerative medial meniscus lesions. The secondary objectives were to identify predictive and prognostic factors and to compare medical versus surgical attitudes so as to draw up an adapted treatment strategy.
  
  
  METHODS
  One hundred and seventy-four patients were included between September 2008 and February 2010, and distributed between a surgical (n=104) and a medical group (n=70). Minimum follow-up was 6 months. Patient satisfaction and health-related quality of life on the SF-36 questionnaire were assessed at 6 months.
  
  
  RESULTS
  No difference emerged between the surgical and medical groups. However, predictive factors for poor results were identified: overweight (p=0.005), cartilage lesions (p=0.035) and meniscus extrusion (p=0.006).
  
  
  CONCLUSIONS
  Results clarified the relation between degenerative meniscus lesions and osteoarthritis, in terms of meniscal incompetence. Meniscal extrusion should be seen as an arthrogenic degenerative meniscus lesion. We recommend a management strategy based on terrain and imaging data (X-ray and MRI), with the aim of providing patient relief while conserving cartilage.
authors.affiliation: Service de Chirurgie Orthopédique et Traumatologique, Hôpital Instruction Militaire Clermont-Tonnerre, 29200 Brest, France. frederic.dubrana@chu-brest.fr
authors.forename: C
authors.initials: C
authors.lastname: Andro
authors.forename: F
authors.initials: F
authors.lastname: Dubrana
authors.forename: G
authors.initials: G
authors.lastname: Marcillaud
authors.forename: J-L
authors.initials: JL
authors.lastname: Rouvillain
authors.forename: F-X
authors.initials: FX
authors.lastname: Gunepin
authors.forename: P
authors.initials: P
authors.lastname: Dewerpe
authors.forename: S
authors.initials: S
authors.lastname: Guilbert
authors.forename: L
authors.initials: L
authors.lastname: Wessely
authors.forename: P
authors.initials: P
authors.lastname: Buisson
authors.forename: P
authors.initials: P
authors.lastname: Chicault
authors.forename: J-P
authors.initials: JP
authors.lastname: Nguyen-Khanh
authors.forename: T
authors.initials: T
authors.lastname: Brune
authors.forename: M
authors.initials: M
authors.lastname: Dhénain
authors.forename: Y
authors.initials: Y
authors.lastname: Maugars
mesh_terms: D000368:Aged; D003161:Compartment Syndromes / Q000209:etiology / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007719:Knee Joint; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011379:Prognosis; D011788:Quality of Life