J Knee Surg 2021; 34(11): 1189-1195
DOI: 10.1055/s-0040-1702191
Original Article

Radiographic Prognostic Factors Relevant to Surgical Outcomes of Arthroscopic Partial Medial Meniscectomy in Elderly Patients with Mild Osteoarthritis

Sang Hoon Park
1   Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
,
Chong Hyuk Choi
2   Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
3   Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Ju Hyung Yoo
1   Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
,
2   Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
4   Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Han Kook Yoon
1   Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
,
Min Jung
2   Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
3   Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Ki Hong Choi
3   Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
1   Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
2   Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
3   Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
› Author Affiliations
Funding None.

Abstract

The aim of this study was to investigate radiographic factors relevant to predict surgical outcomes of arthroscopic partial meniscectomy (APM) in elderly patients with mild osteoarthritis (Kellgren–Lawrence grades 1 and 2). Data of 172 consecutive patients aged >70 years who underwent arthroscopic meniscal surgery were reviewed retrospectively. The patients who met the inclusion criteria were classified into two groups based on the minimal clinically important difference value of the Lysholm knee scoring scale comparing the score of the last visit with that of the preoperative period: group 1 (with clinically significant improvement) and group 2 (without clinically important change). Radiographic factors assessed on X-ray and magnetic resonance images were evaluated using bivariate and logistic regression analyses. A total of 73 patients were included in this study. Bivariate analysis revealed that the extent of meniscus extrusion (p = 0.031), meniscus extrusion ratio (p = 0.001), and grade of meniscus degeneration (p = 0.019) were significantly different between the groups. Multivariate logistic regression analysis showed that the meniscus extrusion ratio was the most important independent predictive factor for surgical outcomes with clinically important changes (coefficient = 0.159, p = 0.009). On receiver operating characteristic (ROC) curve analysis, the cutoff point of the meniscus extrusion ratio discriminating the two groups was 34.2% (sensitivity: 79.3%; specificity: 68.6%; accuracy: 72.6%). Meniscus extrusion ratio was the most relevant predictive factor for discriminating patients with clinically important change. Meniscus extrusion ratio, with the cutoff point of 34.2%, could serve as a guide to determine whether to perform APM in elderly patients with mild osteoarthritis. This is a Level IV, therapeutic case series study.

Note

This study was approved by the institutional review board of our institution (NHIMC 2018–10–007).


Supplementary Material



Publication History

Received: 30 April 2019

Accepted: 07 January 2020

Article published online:
17 March 2020

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