Effect of medial meniscus extrusion on arthroscopic surgery outcome in the osteoarthritic knee associated with medial meniscus tear:a minimum 4-year follow-up  

作　　者：Yu-Xing Wang Zhong-Li Li Ji Li Zhi-Dong Zhao Hao-Ran Wang Cheng Hou Wei Li Chun-Hui Liu 

机构地区：[1]Department of Orthopedics,Chinese PLA General Hospital,Beijing 100853,China [2]Department of Hematology,Chinese PLA General Hospital,Beijing 100853,China

出　　处：《Chinese Medical Journal》2019年第21期2550-2558,共9页中华医学杂志（英文版）

基　　金：This study was supported by a grant from the Beijing Natural Science Foundation(No.7191010).

摘　　要：Background:The potential benefit of arthroscopic surgery for osteoarthritic knee associated with medial meniscus tear is controversial.This study was conducted to determine the effect of pre-operative medial meniscus extrusion(MME)on arthroscopic surgery outcomes in the osteoarthritic knee associated with medial meniscus tear during a minimum 4-year follow-up.Methods:This was a retrospective review of a total of 131 patients diagnosed with osteoarthritic knee associated with medial symptomatic degenerative meniscus tear who underwent arthroscopic surgery from January 2012 to December 2014 and were observed for more than 4 years.Patients were classified into two groups:MME≥3mm(major MME group,n=54)and MME<3mm(non-major MME group,n=77).Clinical assessments,including the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,and radiographic assessments,including the Kellgren-Lawrence(K-L)grade and medial joint space width(JSW),were evaluated pre-operatively and at final follow-up.The longitudinal changes of clinical and radiographic parameters(WOMAC and the medial JSW change,K-L grade progression)were compared between groups unadjusted and adjusted for age,sex,and body mass index.Four-year survival rates(without progression to knee replacement[KR])were also evaluated using a log-rank test and Cox proportional hazard regression model.Results:Major MME was present in 41%of patients.After a minimum 4-year follow-up,the mean WOMAC total and pain scores improved significantly in both groups.However,the medial JSW and K-L grade worsened significantly.Patients with pre-operative majorMMEworsened more inWOMACtotal(adjusted mean difference[MD]3.800,95%confidence interval[CI]:0.900,11.400;P=0.037)and function(adjusted MD 3.100,95%CI:0.700,6.300;P=0.038)scores than patients with pre-operative non-major MME,and no significant difference was observed inWOMACpain and stiffness score between groups.The group with majorMME had significantly higher joint space narrowing(adjusted MD 0.630,95%CI: 1.250, 0.100;P=

关 键 词：OSTEOARTHRITIS KNEE MENISCUS ARTHROSCOPY Prognosis Treatment OUTCOME 

分 类 号：R73[医药卫生—肿瘤]