| Background:The meniscus plays an important role of keeping stability, bearing the load andassimilating shock. Lateral meniscal tear is an extremely common knee sports injury.Meniscal tear brings out the abnormal pressure distribution, decreases the protective effectof cartilage and stability of the knee and damages articular cartilage. People with meniscaltear had knee snapping and twist sympoms that may affect the quality of daily life.Currently accepted treatments are minimally approachs for arthroscopic meniscectomy orsuture. Many researchs have reported that effects of surgery are various. Risk factors ofpoor clinical outcomes of people undergoing meniscetomy were total meniscectomy,degenerative meniscal injury, lateral meniscectomy and cartilage lesion in a meta-analysis.Some studies showed age was also a factor of clinical efficacy. A research found peoplewith meniscus tear,35to65years, the clinical efficacy of arthroscopy and placebo surgerywere uniform.When durations of meniscus tear prolonged, cartilage injury rates also increased.Moreover, people with meniscus tear and cartilage injury with torn knee arthroscopy crowdwas of up to60.1%. The efficacy of arthroscopy for meniscus tear and severe cartilagedamage was controversial. Therefore, this study was to explore the efficacy of arthroscopicsurgery for lateral meniscus tear with various degrees of cartilage damage of lateralcompartment and analyze the factor of clinical outcomes of arthroscopic treatment forpatients with lateral meniscus tear.Objectives:1. Retrospective study on effect of arthroscopy for pure lateral meniscal tears;2. To compare the clinical outcomes of arthroscopic treatment for lateral meniscus tearwith cartilage lesion and pure lateral meniscus tear;3. Comparative analysis the outcomes of arthroscopic surgery for lateral meniscus tear combined with various degrees of cartilage injury of lateral compartment.Methods:1.75patients with a lateral meniscus tear and cartilage demage of lateral compartmentby arthroscopic from2010to2012were assessed as cartilage lesion group.35males and40females were in cartilage lesion group, aged13-75years (average,42.3years).2. According to the Outerbridge classification, cartilage lesion group A had34patientswith grade Ⅰand Ⅱ,22patients with grade Ⅲ in group B and19patients with grade Ⅳin group C. Average age of cartilage lesion group A was37.4years, group B and C were44.5and48.6years respectively.3.100Patients with pure lateral meniscus tears from January to December2012weredefined as control group.50males were in control group, the others were females. The ageof patients ranged from4to64years (average,41.7years). All patients had knee pain feel,physical examination of lateral clearance tenderness test (+) and McMurray test (+).4. Every patient underwent meniscectomy or meniscus suture. The ones that had acartilage lesion underwent radiofrequency-based chondroplasty or microfracture technique.The patients were followed up8-19months (average,13.9months), cartilage lesion group8-43months (mean,21.4months).5. Clinical efficacy was used by the recovery time, cure rate, Lysholm Score and JOAscore of knee. Recovery time was defined to reach the knee which was normal ROM, dailyexercises without pain after time; If one patient was still with abnormal activity or kneepain, recovery time was depended on follow-up time. Cure rate was that the proportion ofpatients with no pain after knee daily exercises and normal ROM and overall number ofpeople.Results:1. All incisions were healed normally. There were not joint infection and hematomacomplications.2. Last follow-up, the recovery time, crue rate and Lysholm score of knee of controlgroup were respectively3.78±1.99months,95%and97．6±6.20points, cartilage lesiongroup8.06±4.71months,76%and92．9±12.0ponts（P＜0.05）.3. The Lysholm Score of cartilage injury A, B and C group were respectively95．5±8.86,95．0±7.88and84．2±16.7point（sP＜0.05), the JOA Score were96．2±8.53,95．9 ±6.29and87．6±12.4points（P＜0.05）. Significance difference was found in cure rateamong three groups (88.2%,81.8%and42.1%, P＜0.05).Conclusions:1. The arthroscopic efficacy of lateral meniscus tear with cartilage lesion of lateralcompartment was significantly worse than pure lateral meniscus.2. Patients with a lateral meniscus tear and Outerbridge grade Ⅳ of cartilage injury inthe knee of lateral compartment, over the age of45, had worst efficacy. Arthroscopictreatment could significantly improve symptoms, but can not completely relieve pain.3. Patients with symptomatic lateral meniscus tear should choose arthroscopictreatment as soon as possible,which can reduce the incidence of cartilage lesion. Moreover,the results of arthroscopic surgery for symptomatic pure lateral meniscal tear weresatisfactory. |
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