title: "Fatigue meniscal tears": a description of the lesion and the results of arthroscopic partial meniscectomy.
abstract: OBJECTIVE
  The purpose of this study was to describe the clinical outcomes of partial meniscectomy in patients with "fatigue meniscal tear", which presents as a non-traumatic tear with abrupt onset of symptoms of a radial tear in the transition between the middle and posterior thirds of the meniscus.
  
  
  METHODS
  We prospectively followed 71 patients with "fatigue meniscal tear" (41 women and 30 men, mean age of 63 years, SD 6.9 years) recruited among 497 patients with isolated medial meniscal lesions treated between January 2006 and June 2011. Inclusion criteria were spontaneous abrupt onset knee pain, minor or no trauma, no radiographic or MRI osteoarthritis, no bone oedema, pre-operative magnetic resonance image of medial meniscus tear, and arthroscopic evaluation demonstrating radial or vertical flap tear in the body to posterior horn junction of the medial meniscus. We followed all patients for a minimum of two years and reviewed their clinical symptoms, physical exam, functional outcome, and patient satisfaction at last follow-up.
  
  
  RESULTS
  The average follow-up was 4.2 years, with a minimum follow-up of two years. Among the 71 patients, there were 59 (83.1 %) good or excellent results and 12 (16.9 %) poor results. These 12 patients demanded further treatment because of persistent pain, with three of the patients developing subchondral bone fracture. All patient complaints and poor outcomes could be identified in the initial six months after surgery. There was no gender difference in the subgroup analysis.
  
  
  CONCLUSIONS
  Our findings indicate that patients with "fatigue meniscal tear" benefit from arthroscopic partial meniscectomy, with only 16.9 % reporting unfavourable results.
  
  
  METHODS
  IV, Cohort study or case series.
authors.affiliation: Institute of Orthopaedic Surgery - Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Rua Ouvidio Pires de Campos, 333, Cerqueira Cesar, São Paulo, SP, Brazil. demange@usp.br.
authors.forename: Marco Kawamura
authors.identifier: http://orcid.org/0000-0003-1999-9478
authors.initials: MK
authors.lastname: Demange
authors.affiliation: Institute of Orthopaedic Surgery - Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Rua Ouvidio Pires de Campos, 333, Cerqueira Cesar, São Paulo, SP, Brazil.
authors.forename: Riccardo Gomes
authors.initials: RG
authors.lastname: Gobbi
authors.affiliation: Institute of Orthopaedic Surgery - Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Rua Ouvidio Pires de Campos, 333, Cerqueira Cesar, São Paulo, SP, Brazil.
authors.forename: Gilberto Luis
authors.initials: GL
authors.lastname: Camanho
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D012421:Rupture / Q000601:surgery; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome
keywords: Arthroscopy; Injuries; Knee; MeSH terms; Meniscectomy; Menisci; Meniscus tear; Osteoarthritis; Tibial