LOS ANGELES — No differences were found in objective and subjective results between patients with peripheral nondegenerative medial meniscus tears treated with trephination alone and a control group without meniscus tears, according to results presented at the Arthroscopy Association of North America Annual Meeting.
“Nondisplaceable, nondegenerative peripheral vertical medial meniscus tears can heal with trephination alone at the time of ACL reconstruction,” K. Donald Shelbourne, MD, said during his presentation. “Subjective functional scores are not statistically different than those of patients with intact menisci. Radiographic changes are uncommon and, when present, are minor.”
Shelbourne and colleagues matched 419 patients with peripheral nondegenerative medial meniscus tears (MMTs) of greater than 1 cm but less than half of the circumference of the meniscus, no lateral meniscus tears, no arthritic changes on radiographs before surgery and no bilateral knee involvement with a control group of 426 patients who met the same criteria but had no MMTs. Objective data included IKDC objective evaluation, whereas subjective data consisted of IKDC and Cincinnati Knee Rating System survey scores.
K. Donald Shelbourne
Overall, the researchers obtained objective follow-up data for 191 patients in the study group at an average of 5.6 years and 200 patients in the control group at an average of 5.9 years. Subjective survey follow-up was obtained for 312 patients in the study group at an average of 7 years and 343 patients in the control group at an average of 7.1 years.
“Objective results were not statistically different from the patients who returned for research visits and those who returned surveys only,” Shelbourne said.
IKDC scores for both the study and control groups were identical to Cincinnati Knee Rating scores, according to study results. Shelbourne noted 95% of the study group had normal X-rays vs. 92% of patients in the control group.
Subsequent retear requirement removal and subsequent tear rate was 16.3% in the study group and 5.8% in the control group. Additionally, Shelbourne and colleagues found the mean time for retear was 3.6 years. – by Casey Tingle
Shelbourne KD, et al. Paper #SS-69. Presented at: Arthroscopy Association of North America Annual Meeting. April 23-25, 2015; Los Angeles.
Disclosure: Shelbourne reports no relevant financial disclosures.