Arthroscopic pie-crusting release of the posteromedial c omplex of the knee for surgical treatment of medial meniscus injury

Abstract Background: The posteromedial complex (PMC), including the posterior part of the MCL and the posterior oblique ligament (POL), has a restrictive effect on the opening of the posteromedial gap of the knee in the half-extension position. We evaluated the radiological and clinical results of pie-crusting release of the PMC for arthroscopic meniscal surgery in tight knees.Methods: Sixty patients with posterior injury of the medial meniscus were reviewed. All patients accepted arthroscopic pie-crusting release of the PMC. Fourty patients accepted meniscoplasty, and 20 patients accepted meniscal suturing. To evaluate the arthroscopic opening of the medial gap in 20° half-extension under 11-kg valgus stress, the width of the medial space before and after release were measured. During follow-up, the medial stability was evaluated by radiographic measurements of the joint space width (JSW). MRI was conducted to evaluate healing of the MCL and meniscus. Knee functions were evaluated using VAS, Lysholm, IKDC and Tegner scoring systems.Results: In all patients, meniscus operations were performed without iatrogenic cartilage injury. After PMC release, the arthroscopic width of the medial space was 5.7 ± 0.5 mm, larger than that before release (2.5 ± 0.5 mm, p < 0.01). The follow-up time was 21.93 ± 7.04 months, there was no residual valgus laxity of the knee. The radiographic JSW was 5.97 ± 0.8 mm preoperatively, 9.2 ± 1.1 mm in the 1st week postoperatively, and 6.1 ± 0.9 mm by the 3rd postoperative month, showing no differences between preoperative and 3 months postoperative measurement (p > 0.05). For sutured meniscus, MRI showed healing in 15 patients while five had two-grade abnormal signals. VAS, Lysholm, IKDC and Tegner scores were 1.80 ± 0.51, 80.08 ± 3.74, 82.17 ± 4.64 and 5.48 ± 0.59, respectively, showing significant differences compared with the preoperative scores (5.57 ± 0.69, 48.17 ± 4.22, 51.42 ± 4.02 and 3.20 ± 0.68, respectively, P < 0.01).Conclusions: Pie-crusting release of the PMC can increase the posteromedial space and improve the visual field of the knee under arthroscopy, while neither causing no residual valgus instability of the knee nor affecting the clinical outcome at the final follow-up.

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Arthroscopic pie-crusting release of the posteromedial complex of the knee for surgical treatment of the medial meniscus injury

10.21203/rs.2.24229/v1 ◽

2020 ◽

Author(s):

Xu Han ◽

Peizhao Wang ◽

Jinyang Yu ◽

Xiao Wang ◽

Honglue Tan

Keyword(s):

Medial Meniscus ◽

Joint Space Width ◽

Posterior Part ◽

Scoring Systems ◽

Clinical Results ◽

Joint Space ◽

Valgus Stress ◽

Radiographic Measurements ◽

Meniscal Surgery

Abstract Background: Arthroscopic narrow posteromedial gap of the knee may cause the failure of meniscus operation. The posteromedial complex (PMC) of the knee, including the posterior part of MCL and posterior oblique ligament, has a restrictive effect on the opening of the posteromedial gap of the knee in the half-extension position. Thus, we evaluated the radiological and clinical results of pie-crusting release of PMC for arthroscopic meniscal surgery in tight knees.Methods : Sixty patients with posterior injury of the medial meniscus were reviewed. All patients accepted arthroscopic pie-crusting release of the PMC. Fourty patients accepted meniscoplasty, and 20 patients accepted meniscuc suturing. To evaluate the arthroscopic opening of the medial gap in 20°half-extension under 11-kg valgus stress, the width of the medial space before and after release were measured. During follow-up, the medial stability was evaluated by radiographic measurements of the joint space width (JSW) in 20°half-extension. MRI was conducted to evaluate the healing of MCL and meniscus. Knee functions were evaluated using VAS, Lysholm, IKDC and Tegner scoring systems. Results: In all patients, meniscus operations were performed without iatrogenic cartilage injury. After PMC release, the arthroscopic width of the medial space was 5.7 ±0.5 mm, showing larger than that before release (2.5 ± 0.5 mm) (p < 0.01). The follow-up time was 21.93±7.04 months, there was no residual valgus laxity of the knee. The radiographic JSW was 5.97 ± 0.8 mm preoperatively, 9.2 ± 1.1 mm in the postoperative 1st week, and 6.1±0.9 mm in the postoperative 3rd months, showing no differences between pre- and postoperative 3rd month (p > 0.05). For sutured meniscus, MRI showed healing in 15 patients while five had two-grade abnormal signals. VAS, Lysholm, IKDC and Tegner scores were 1.80±0.51, 80.08±3.74, 82.17±4.64 and 5.48±0.59, respectively, showing significant differences compared with the preoperative scores (5.57±0.69, 48.17±4.22, 51.42±4.02 and 3.20±0.68, respectively) (P < 0.01).Conclusion s: Pie-crusting release of PMC can increase the posteromedial space and improve the visual field of the knee under arthroscopy, and this technique do neither produce residual valgus instability of the knee nor affect clinical outcome at the final follow-up.

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Is it possible to use stress radiographs as a tool to diagnose medial meniscus posterior root tears?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00073 ◽

2017 ◽

Vol 5 (2_suppl2) ◽

pp. 2325967117S0007

Author(s):

Ali Engin Daştan ◽

Elcil Kaya Biçer ◽

Hüseyin Kaya ◽

Emin Taşkıran

Keyword(s):

Medial Meniscus ◽

Weight Bearing ◽

Joint Space Width ◽

Joint Space ◽

X Rays ◽

Meniscal Extrusion ◽

Valgus Stress ◽

Varus Stress ◽

The Difference ◽

Space Width

Aim: Medial meniscus posterior root tear (MMPRT) causes meniscal extrusion, loss of meniscus function, arthritic changes. Clinical history, physical examination and magnetic resonance imaging (MRI) findings are useful for the diagnosis of MMPRT. The aim of this study is to evaluate the utility of stress X-rays in the diagnosis of MMPRT. Methods: Twenty patients who had undergone high tibial osteotomy between March 2015 and May 2016 and whose preoperative bilateral varus and valgus stress x-rays (Telos device) along with weight bearing x-rays were available were included. These patients were grouped into two according to integrity of posterior roots of their medial menisci; there were ten patients both in the study and control groups. Lateral joint space width (LJW) on varus stress x-rays, medial joint space width (MJW) on valgus stress x-rays as well as LJW and MJW on weight bearing x-rays were measured bilaterally. Intragroup comparisons of joint space widths between index and opposite knees were performed. Differences of MJW and LJW between index and opposite knees were calculated. Differences of joint space widths between stress x-rays and weight bearing x-rays were also calculated. The changes in joint space widths between the two groups were compared. Statistical analyses were performed utilizing SPSS 18.0. Significance level was set at 0.05. Results: In MMPRT group, opening of LJ space of index knees under varus stress was greater than that of opposite knees (Index: (mean±SD) 10,27±1,17 mm, opposite: 8,61±1,37 mm; p<0,0001). In the control group the difference was not significant (Index: 9,29±2,55 mm, opposite: 9,68±1,44 mm; p=0,566). The difference in the opening of LJW (under varus stress) between index and opposite knees was significantly greater in the study group (p=0,013). The difference between LJW under weight-bearing and varus stress conditions was significantly greater in the study group. (Study: 3,64±0.217 mm, control:2,28±0,182 mm, p=0.018). Conclusions: The findings of this study showed that in patients who had MMPRTs, an increased opening in the LJW was observed under varus stress conditions. This may be relevant with the fact that when varus stress is applied, meniscal extrusion is increased in case of a MMPRT. Stress x-rays could be a useful tool in the diagnosis of MMPRTs. Further studies are needed to determine the sensitivity and specificity of this diagnostic tool.

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Does Transection of the Superficial MCL During HTO Result in Progressive Valgus Instability?

The American Journal of Sports Medicine ◽

10.1177/03635465211059162 ◽

2021 ◽

pp. 036354652110591

Author(s):

Joo-Hwan Kim ◽

Dong Jin Ryu ◽

Sung-Sahn Lee ◽

Seung Pil Jang ◽

Jae Sung Park ◽

...

Keyword(s):

Case Series ◽

Preoperative Assessment ◽

International Knee Documentation Committee ◽

Clinical Results ◽

Osteotomy Site ◽

Tibial Osteotomy ◽

Level Of Evidence ◽

Valgus Stress ◽

Valgus Instability

Background: During high tibial osteotomy (HTO), the superficial medial collateral ligament (sMCL) is cut or released at any degree to expose the osteotomy site and achieve the targeted alignment correction according to the surgeon’s preference. However, it is still unclear whether transection of sMCL increases valgus laxity. Purpose: We aimed to assess the outcomes and safety of sMCL transection, especially focusing on iatrogenic valgus instability. Study Design: Case series; Level of evidence, 4. Methods: Seventy-two patients (89 knees) who underwent medial open wedge HTO (MOWHTO) with transection of the sMCL between October 2013 and September 2018 were retrospectively investigated. Clinical evaluations, including the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner and Lysholm scores, were performed preoperatively and at 2 years postoperatively. The radiographic parameters hip-knee-ankle (HKA) angle, joint line convergence angle on standing radiographs (standing JLCA), and weightbearing line (WBL) ratio were assessed preoperatively and at 3 months, 6 months, 1 year, and 2 years postoperatively. To evaluate valgus laxity, we assessed the valgus JLCA and medial joint opening (MJO) at the aforementioned time points using valgus stress radiographs. Results: All clinical results at the 2-year follow-up were significantly improved compared with those obtained at the preoperative assessment ( P < .001). The postoperative HKA angle significantly differed from the preoperative one, and no significant valgus progression was observed during follow-up (preoperative, 8.5°± 2.7°; 3 months, –3.5°± 2.0°; 6 months, –3.2°± 2.3°; 1 year, –3.1°± 2.3°; 2 years, –2.9°± 2.5°; P < .001) The mean WBL ratio was 62.5% ± 9.0% at 2 years postoperatively. The postoperative valgus JLCA at all follow-up points did not significantly change compared with the preoperative valgus JLCA (preoperative, –0.1°± 2.1°; 3 months, –0.2°± 2.4°; 6 months, –0.1°± 2.5°; 1 year, 0.1°± 2.5°; 2 years, 0.2°± 2.2°) The postoperative MJO at all follow-up points did not significantly change compared with the preoperative MJO (preoperative, 7.1 ± 1.7 mm; 3 months, 7.0 ± 1.7 mm; 6 months, 6.9 ± 1.9 mm; 1 year, 6.7 ± 1.8 mm; 2 years, 6.8 ± 1.8 mm). Conclusion: Transection of the sMCL during MOWHTO does not increase valgus laxity and could yield desirable clinical and radiographic results.

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Does improved radiographic alignment truly enhance dynamic functional balance?

Studies in Health Technology and Informatics - Research into Spinal Deformities 9 ◽

10.3233/shti210433 ◽

2021 ◽

Author(s):

R Haddas ◽

S Kisinde ◽

D Mar ◽

I Lieberman

Keyword(s):

Patient Reported Outcomes ◽

Added Value ◽

Functional Balance ◽

Radiographic Measurements ◽

Patient Reported ◽

Before And After ◽

Gait Abnormalities ◽

The Relationship ◽

Radiographic Alignment

Prospective, concurrent-cohort study. To establish the relationship between radiographic alignment parameters and functional CoE measurements at one week before and at three months after realignment surgery in ADS patients. Adult degenerative scoliosis (ADS) represents a significant healthcare burden with exceedingly high and increasing prevalence, particularly among the elderly. Radiographic alignment measures and patient-reported outcomes currently serve as the standard means to assess spinal alignment, deformity, and stability. Neurological examinations have served as qualitative measures for indicating muscle strength, motor deficits, and gait abnormalities. Three-Dimensional motion analysis is increasingly being used to identify and measure gait and balance instability. Recently, techniques have been established to quantify balance characteristics described by Dubousset as the “cone of economy” (CoE). The relationship between radiographic alignment parameters and CoE balance measures of ADS patients before and after realignment surgery is currently unknown. 29 ADS patients treated with realignment surgery. Patients were evaluated at one week before realignment surgery and at their three-month follow-up examination. During each evaluation, patients completed self-reported outcomes (visual analog scales for pain, Oswestry Disability Index, SRS22r) and a functional balance test. Mean changes in dependent measures from before to after surgery were compared using paired t-tests. Pearson correlations were used to test for significant correlations between changes in radiographic and CoE measures. Significant improvements were found for all patient-reported outcomes, in several radiographic measures, and in CoE measures. Improvements of scoliosis Cobb angle, coronal pelvic tilt, lumbar lordosis, and thoracic kyphosis showed significant correlations with CoE sway and total distance measures at both the center of mass and center of the head. Improved radiographic alignment measures significantly correlated with improved CoE balance measures among ADS patients treated with realignment surgery at their three-month follow-up. These findings indicate that functional balance evaluations when used in conjunction with radiographic measurements, may provide a more robust and improved patient-specific sensitivity for postoperative assessments. CoE balance may represent a new measure of added value for surgical intervention of ADS.

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Association between disease progression and depression onset in persons with radiographic knee osteoarthritis

Rheumatology ◽

10.1093/rheumatology/keaa141 ◽

2020 ◽

Vol 59 (11) ◽

pp. 3390-3399

Author(s):

Alan M Rathbun ◽

Michelle D Shardell ◽

Alice S Ryan ◽

Michelle S Yau ◽

Joseph J Gallo ◽

...

Keyword(s):

Disease Progression ◽

Disease Severity ◽

Gait Speed ◽

Joint Space Width ◽

Joint Space ◽

Knee Oa ◽

Increased Risk ◽

Pain Subscale ◽

Space Width

Abstract Objectives Osteoarthritis (OA) disease progression may lead to deteriorating psychosocial function, but it is unclear what aspects of disease severity are related to the onset of depression. This study assessed which components of OA disease progression cumulatively contribute to depression onset in persons with radiographic knee OA. Methods Osteoarthritis Initiative participants (n = 1651) with radiographic disease (Kellgren-Lawrence grade ≥2) in one or both knees and below the screening threshold for probable depression [Center for Epidemiological Studies Depression (CES-D) scale <16] at baseline were included. Disease severity was measured from baseline to the third annual follow-up visit using joint space width, 20-meter gait speed, and the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, each categorized into quintiles. Depression onset (CES-D ≥ 16) was assessed annually at four follow-up visits. Marginal structural models that account for time-dependent confounding and attrition evaluated the association between each time-varying disease severity measure and depression onset. Results Each disease severity measure exhibited a non-linear relationship concerning the probability of depression onset, with the higher quintiles generally being associated with a larger risk. The highest quintile (relative to the lowest) of joint space width and gait speed were both significantly associated with depression onset. By contrast, none of the higher pain quintiles compared with the lowest were significantly associated with the onset of depression. Conclusion Faster disease progression as measured by either worsening structural severity or decreasing physical performance corresponds to an increased risk of depression among individuals with radiographic knee OA.

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Clinical Results of Percutaneous Transluminal Angioplasty and Stenting for Intracranial Vertebrobasilar Atherosclerotic Stenoses and Occlusions

Interventional Neuroradiology ◽

10.1177/15910199040100s205 ◽

2004 ◽

Vol 10 (2_suppl) ◽

pp. 21-25 ◽

Cited By ~ 4

Author(s):

M. Tsuura ◽

T. Terada ◽

O. Masuo ◽

T. Tsumoto ◽

H. Yamaga ◽

...

Keyword(s):

Clinical Results ◽

Transluminal Angioplasty ◽

Morbidity Rate ◽

Cerebellar Haemorrhage ◽

Total Occlusion ◽

Vertebrobasilar Artery ◽

Before And After ◽

High Risk Lesion ◽

Angioplasty And Stenting

Eighteen patients with intracranial vertebrobasilar stenosis and occlusion were treated by PTA or stenting. In 11 of 18 cases, only PTA was performed and in seven of 18 cases, we used stents. The mean stenosis before and after PTA/stenting was 82.8% and 22.3%, respectively. In 11 cases of PTA only, the stenotic rate decreased from 81.8% to 29.6%, while 85.0% of the stenotic rate remarkably reduced to 6.0% in seven cases of stenting. The 30 days morbidity and 30 days mortality rate were 5.5% and 5.5%, respectively. There was only one haemorrhagic complication (cerebellar haemorrhage) in cases of stenting, and no ischemic events during or after the procedures. Restenosis (more than 50% stenosis) occurred in four of 18 cases (22.2%) during mean follow-up period of 12 months. Two patients with VA occlusion before treatment, developed restenosis and reocclusion. Complete total occlusion seems to be a high-risk lesion and strict follow-up is required. In this study, PTA/stenting for intracranial vertebrobasilar artery stenosis or occlusion is an effective treatment, but strict indications may be required because procedure-related 30 days morbidity rate was 5.5% in addition to unclear natural history.

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Distraction of facets with intraarticular spacers as treatment for lumbar canal stenosis: report on a preliminary experience with 21 cases

Journal of Neurosurgery Spine ◽

10.3171/2011.8.spine11249 ◽

2013 ◽

Vol 19 (6) ◽

pp. 672-677 ◽

Cited By ~ 33

Author(s):

Atul Goel ◽

Abhidha Shah ◽

Madan Jadhav ◽

Santhosh Nama

Keyword(s):

Root Canal ◽

Spinal Canal ◽

Joint Space ◽

Degenerative Disease ◽

Spinal Segment ◽

Lumbar Degenerative Disease ◽

Lumbar Canal Stenosis ◽

Canal Stenosis ◽

Before And After

Object The authors report their experience in treating 21 patients by using a novel form of treatment of lumbar degenerative disease that leads to canal stenosis. The surgery involved distraction of the facets using specially designed Goel intraarticular spacers and was aimed at arthrodesis of the spinal segment in a distracted position. The operation is based on the premise that subtle and longstanding facet instability, joint space reduction, and subsequent facet override had a profound and primary influence in the pathogenesis of degenerative lumbar canal stenosis. The surgical technique and the rationale for treatment are discussed. Methods Between April 2006 and January 2011, 21 cases of lumbar degenerative disease resulting in characteristic lumbar canal stenosis were treated in the authors' department with the proposed technique. The patients were prospectively analyzed. There were 15 men and 6 women who ranged in age from 48 to 71 years (mean 58 years). Nine patients underwent 1-level and 12 patients underwent 2-level treatment. Surgery involved wide opening of the articular joint, denuding of the articular capsule/endplate cartilage, distraction of the facets, and forced impaction of Goel intraarticular spacers. Bone graft pieces obtained by sectioning the spinous processes were placed within and over the joint and in the midline over the adequately prepared host area of laminae. The Oswestry Disability Index and visual analog scale were used to clinically assess the patients before and after surgery and at follow-up. The alterations in the physical architecture of spinal canal and intervertebral foramen dimensions were evaluated before and after placement of the intrafacet implant and after at least 6 months of follow-up. Results All patients had varying degrees of relief from symptoms of local back pain and radiculopathy. Impaction of spacers within the facet joints resulted in an increase in the spinal canal and intervertebral root canal dimensions (mean 2.33 mm), reduction of buckling of the ligamentum flavum, and reduction of the extent of bulge of the disc into the spinal canal. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. No patient worsened neurologically after treatment. During the follow-up period, all patients had evidence of segmental bone fusion. No patient underwent reexploration or further surgery of the lumbar spine. Conclusions Impaction of the spacers within the articular cavity after facet distraction resulted in reversal of several effects of spine degeneration that had caused spinal and root canal stenosis. The safe, firm, and secure stabilization at the fulcrum of lumbar spinal movements provided a ground for segmental spinal arthrodesis. The immediate postoperative and lasting recovery from symptoms suggests the validity of the procedure.

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Changes in Knee Joint Space Width in Treatment with a New Hyaluronic-Based Hydrogel

Acta Medica Marisiensis ◽

10.1515/amma-2017-0017 ◽

2017 ◽

Vol 63 (3) ◽

pp. 125-128

Author(s):

Octav Marius Russu ◽

Andrei Marian Feier ◽

Tudor Sorin Pop ◽

Marcela Todoran ◽

István Gergely

Keyword(s):

Hyaluronic Acid ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Joint Space Narrowing ◽

Joint Space Width ◽

Joint Space ◽

One Year ◽

A Minor ◽

Space Width

AbstractObjective: Our purpose was to assess the effect of a new hyaluronic acid-based (Hymovis®) injections on joint space width narrowing in patients diagnosed with knee osteoarthritis.Methods: A prospective clinical trial was conducted in the Department of Orthopedics and Traumatology II from the Clinical County Hospital, Tîrgu Mureș, Romania. Thirty-five patients diagnosed with idiopathic knee osteoarthritis received two intraarticular injections with hyaluronic acid-based hydrogel (24 mg of hyaluronic acid/3 ml) at one-week interval. Anteroposterior radiographs were obtained before the injections, at six and twelve months after. Minimum joint space width was measured by two senior orthopaedics surgeons at each follow up. Each radiograph was measured again by the same evaluators two weeks apart.Results: Thirty-one patients were present at the final follow-up. A minor reduction in mean weight was noticed (from 82.2 kg ± 16.2 kg to 80.9 kg ± 16.0, p > 0.398) without any correlation with joint space width narrowing. There were no major changes at the first follow up (6 months) regarding joint space narrowing. A reduction in joint space width was observed however at 12 months varying from 4.4 mm (SD ± 1.64, range 1.8-7.1) at the first assessment to 4.3 mm (SD ± 1.26, range 0.0-6.8) at the final follow-up but with no statistical difference (p=0.237).Conclusion: No significant modification in joint space width at the final follow-up secondarily proved that two injections of Hymovis® may slow down narrowing in the knee joint space over a one-year period.

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Sensitivity-to-change and validity of semi-automatic joint space width measurements in hand osteoarthritis: a follow-up study

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2016.02.002 ◽

2016 ◽

Vol 24 (7) ◽

pp. 1172-1179 ◽

Cited By ~ 6

Author(s):

W. Damman ◽

M.C. Kortekaas ◽

B.C. Stoel ◽

R. van 't Klooster ◽

R. Wolterbeek ◽

...

Keyword(s):

Joint Space Width ◽

Joint Space ◽

Hand Osteoarthritis ◽

Sensitivity To Change ◽

Follow Up Study ◽

Width Measurements ◽

Space Width

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Does meniscectomy have any advantage over conservative treatment in middle-aged patients with degenerative medial meniscus posterior root tear?

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04632-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Nam-Hun Lee ◽

Hyoung-Yeon Seo ◽

Myung-Jin Sung ◽

Bo-Ram Na ◽

Eun-Kyoo Song ◽

...

Keyword(s):

Conservative Treatment ◽

Clinical Outcomes ◽

Medial Meniscus ◽

Joint Space ◽

Posterior Root ◽

Root Tear ◽

Aged Patients ◽

Posterior Root Tear ◽

Arthroscopic Meniscectomy

Abstract Background The best treatment for degenerative medial meniscus posterior root tear (MMPRT) remains controversial. This study aimed to compare the clinical and radiological outcomes of arthroscopic meniscectomy and conservative treatment for degenerative MMPRT. Methods From January 2007 to December 2014, 146 patients (Meniscectomy group, 90; Conservative group, 56) were evaluated. Clinical outcomes were assessed using the Visual Analog Scale, International Knee Documentation Committee subjective scoring scale, Tegner activity scale, and Lysholm knee scoring scale at the final follow-up. Radiologic outcomes evaluated the progression of osteoarthritis (OA) according to the Kellgren-Lawrence (K-L) classification. We compared the hip-knee-ankle angle (HKAA), medial proximal tibial angle, tibial posterior slope angle, and width of medial joint space. After an average follow-up of 6.3 years, the survivorship was analyzed using the Kaplan–Meier method. Results All clinical outcomes were significantly improved in both groups after treatment, with no significant differences between the two groups at the final follow-up. The progression of OA according to the K-L classification, HKAA and width of medial joint space was significantly advanced in the meniscectomy group (p = 0.03, 0.04, 0.03, respectively). The 10-year survival rates in the meniscectomy and conservative groups were 87 and 88%, respectively. Conclusions This study demonstrated that both conservative treatment and meniscectomy provided symptomatic relief. However, it was confirmed that OA progression was more severe in the meniscectomy. We conclude that arthroscopic meniscectomy had no advantage over conservative treatment in terms of clinical outcomes and OA progression in middle-aged patients with MMPRT. Level of evidence Level III; retrospective comparative study.

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