title: Meniscectomy versus meniscal repair: 10 years radiological and clinical results in vertical lesions in stable knee.
abstract: BACKGROUND
  Surgical management of meniscal lesion consists of either a meniscectomy or meniscal repair. Although repair offers immediate recovery after surgery, it is also associated with higher rates of revision. A meniscectomy, on the other hand is known to be associated with an early onset of osteoarthritis. The present study compared clinical and radiological results at 10 years between meniscectomy and meniscal repair in isolated vertical lesion in an otherwise stable knee. The hypothesis was that repair shows functional and radiological benefit over meniscectomy.
  
  
  METHODS
  A multi-centric retrospective comparative study of 32 patients (24 male, 8 female). Mean follow-up was 10.6 years (range, 10-13 years). There were 10 meniscal repairs (group R) and 22 meniscectomies (group M), in 17 right and 15 left knees. Mean age at surgery was 33.45±12.3 years (range, 9-47 years). There were 28 medial and 4 lateral meniscal lesions; 26 were in the red-red zone and 6 in red-white zone.
  
  
  RESULTS
  Functional score: KOOS score was significantly higher in group R than M on almost all parameters: 98±4.69 versus 77.38±21.97 for symptoms (P=0.0043), 96.89±7.20 versus 78.57±18.9 for pain (P=0.0052), 99.89±0.33 versus 80.88±19.6 for daily life activities (P=0.0002), 96.11±9.83 versus 54.05±32.85 for sport and leisure (P=0.0005), but 91±16.87 versus 68.15±37.7 for quality of life (P=0.1048). Radiology score: in group R, 7 patients had no features of osteoarthritis, and 2 had grade 1 osteoarthritis. In group M, 5 patients had grade 1 osteoarthritis, 10 grade 2, 3 grade 3 and 3 grade 4. Mean quantitative score was 0 (mean, 0.22±0.44) in-group R and 2 (mean, 2.19±0.98) in group M (P<0.0001).
  
  
  CONCLUSIONS
  At more than 10year's follow-up, functional scores were significantly better with meniscal repair than meniscectomy on all parameters of the KOOS scale except quality of life. Functional and radiological scores correlated closely. These results show that meniscal repair for vertical lesions in stable knees protects against osteoarthritis and is therefore strongly recommended.
  
  
  METHODS
  IV; retrospective study.
authors.affiliation: Clinique du Diaconat, 50, avenue des Vosges, 67000 Strabourg, France. Electronic address: lutzortho@wanadoo.fr.
authors.forename: C
authors.initials: C
authors.lastname: Lutz
authors.affiliation: 2, rue du Docteur-Marcland, 87025 Limoges cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Dalmay
authors.affiliation: Clinique Maussins-Nollet, 67, rue de Romainville, 75019 Paris, France.
authors.forename: F P
authors.initials: FP
authors.lastname: Ehkirch
authors.affiliation: 118, rue Jean-Mermoz, 13008 Marseille, France.
authors.forename: T
authors.initials: T
authors.lastname: Cucurulo
authors.affiliation: CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Laporte
authors.affiliation: CHU Cavale-Blanche, 29200 Brest, France.
authors.forename: G
authors.initials: G
authors.lastname: Le Henaff
authors.affiliation: Medipôle, 45, rue de Gironis, 31036 Toulouse cedex 1, France.
authors.forename: J F
authors.initials: JF
authors.lastname: Potel
authors.affiliation: Centre hospitalier de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France.
authors.forename: N
authors.initials: N
authors.lastname: Pujol
authors.affiliation: Département d'orthopédie traumatologie, CHRU de Caen-Côte-de-Nacre, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: G
authors.initials: G
authors.lastname: Rochcongar
authors.affiliation: Département d'orthopédie traumatologie, CHRU de Caen-Côte-de-Nacre, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France.
authors.forename: E
authors.initials: E
authors.lastname: Salledechou
authors.affiliation: Centre hospitalier de Luxembourg, 78, rue d'Eich, 1460 Luxembourg, Luxembourg.
authors.forename: R
authors.initials: R
authors.lastname: Seil
authors.affiliation: Clinique Mutualiste, 3, rue Robert-de-la-Croix, 56324 Lorient cedex, France.
authors.forename: F-X
authors.initials: FX
authors.lastname: Gunepin
authors.affiliation: Centre orthopédique Santy, 24, avenue Paul-Santy, 69008 Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Sonnery-Cottet
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000209:etiology; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology*; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D013177:Sports; D000070600:Tibial Meniscus Injuries; D055815:Young Adult
keywords: Knee; Long-term; Meniscal repair; Meniscectomy