Peter Rockborn

Long-term results of meniscus repair and meniscectomy: a 13-year functional and radiographic follow-up study.

Abstract This study investigated the long-term outcome of common meniscus treatment (meniscectomy, repair). A consecutive series of 30 patients with open meniscus repair were compared retrospectively to 30 patients who had an arthroscopic partial or subtotal meniscectomy. The groups were matched according to sex, age, meniscus lesion, and follow-up time. The patients were aged 13–43 years at the time of operation; all had intact cruciate ligaments, and none had had previous surgery on the knee. Patients were reexamined at a mean of 13 years after the operation. In addition, for a subgroup of 22 matched pairs, data were available from a 7-year follow-up. Four of the repaired menisci did not heal, and another three reruptured during the 13-year follow-up; these menisci were all excised (23%). Meniscal remnant surgery was needed in 6 cases (20%) after initial meniscectomy. At the 13-year follow-up there was no difference between the groups in knee function, subjective complaints, or manual findings. Almost 90% of the patients in both groups had no knee problems during daily activities. At the late follow-up radiographic signs for bone spurs, sclerosis, or flattening of the femoral condyle were found in around half ¶of the cases in each group. Three patients (10%) with initial repair and ¶8 (27%) with meniscectomy had minor joint space reduction, but no patient had more severe radiographic changes. After 7 years (subgroup) joint space reduction was more common after initial meniscectomy than after repair (P < 0.05). After 13 years the incidence and severity of arthrosis did not differ significantly between the two groups, even when only the successful repairs were compared to meniscectomy (P = 0.06).

Outcome of arthroscopic meniscectomy a 13-year physical and radiographic follow-up of 43 patients under 23 years of age

We reexamined 43 patients with stable knees at a mean of 13 years after arthroscopic meniscectomy. The patients had a maximum age of 22 years at the operation and no patient had had previous surgery on the involved knee. At the follow-up examination, no differences in range of motion, muscle strength or tibial A/P displacement were seen between the operated and the nonoperated knees and 36 patients had no problem with their knee in daily life. Radiographic changes were found in the operated knee in 20 patients and in the nonoperated knee in 5 patients. 8 patients had a reduction of the joint space on the involved side, but none had more severe changes. Cartilage fibrillation at the index arthroscopy did not increase the radiographic changes at follow-up, but radiographic changes were commoner after subtotal meniscectomy (7/8) than after partial meniscectomy (17/35). These findings are similar to previous studies of arthroscopic meniscectomy of medium duration and do not differ considerably from studies of open meniscectomy.

Results of open meniscus repair

We have followed for 13 years a consecutive series of 31 patients who had open repair of a torn meniscus. They were between 13 and 43 years of age at the time of operation and all had intact stabilising ligaments. Comparison was made with a matched group of normal subjects of similar age and level of activity. The total rate of failure after meniscal repair was 29%; three of the repaired menisci did not heal and six reruptured during the follow-up period. At follow-up 80% of the patients had normal knee function for daily activities. Radiological changes were found in seven. Two had reduction of the joint space (Ahlbäck grade 1), one with successful and one with failed repair. In the control group of uninjured subjects one knee showed Fairbank changes but none had changes according to Ahlbäck. The incidence of radiological changes did not differ between the group with meniscal repair and the control group but knee function was reduced after meniscal repair (p < 0.001). We conclude that the long-term results of meniscal repair in stable knees are good with nearly normal function and a low incidence of low-grade radiological changes.

Arthroscopic meniscectomy : Treatment costs and postoperative function in a historical perspective

We report short-term data from 82 consecutive patients with arthroscopic meniscectomy 1995-1998 in stable knees and without severe cartilage changes. All patients were treated as outpatients, the operating time was, on average, 23 SD12 minutes and 3 of 4 patients were back at work within 1 week. Almost half of the patients still had some knee problems 3 months after surgery, but thereafter a substantial improvement was seen. We also report original data from a consecutive series of patients having arthroscopic meniscectomy 1980-81. In that series, the frequency of total meniscectomies was higher, the operating time longer, but the time to recovery was shorter than in 1995-98. In contrast to 1995-98, most of the patients in 1980-81 were followed by the doctor and had supervised rehabilitation. However, sick leave was similar in the two series. The total costs for an arthroscopic meniscectomy in 1998 was less than half the costs in 1980-81. We conclude that the improved technique for arthroscopic meniscectomy during the last 15-20 years and less supervised rehabilitation have reduced the costs, but not the recovery time.

Risk factors for acute and overuse sport injuries in Swedish children 11 to 15 years old: what about resistance training with weights?

To determine the 1‐year self‐reported incidence of overuse and traumatic sport injuries and risk factors for injuries in children participating in a summer sports camp representing seven different sports. 4363 children, 11 to 15 years old participating in a summer camp in seven different sports answered a questionnaire. Injury in this cross‐sectional study was defined as a sport‐related trauma or overload leading to pain and dysfunction preventing the person from participation in training or competition for at least 1 week. A number of risk factors for injury were investigated such as sex, age, number of hours spent on training in general, and on resistance training with weights. Nearly half [49%, 95% confidence interval (CI) 48–51%] of the participants had been injured as a result of participation in a sport during the preceding year, significantly more boys than girls (53%, 95% CI 50–55% vs 46%, 95% CI 43–48%; P < 0.001). Three factors contributed to increased incidence of sport injuries: age, sex, and resistance training with weights. Time spent on resistance training with weights was significantly associated with sport injuries in a logistic regression analysis. In children age 11 to 15 years, the risk of having a sport‐related injury increased with age and occurred more often in boys than in girls. Weight training was the only modifiable risk factor that contributed to a significant increase in the incidence of sport injuries.