Results of Arthroscopic Medial Meniscectomy in Patients With Grade IV Osteoarthritis of the Medial Compartment

Purpose: To determine the clinical results of arthroscopic medial meniscectomy in patients with Outerbridge grade IV osteoarthritis who underwent an arthroscopic medial meniscectomy. Methods: From March 1998 to December 2001, 617 patients underwent arthroscopic medial meniscectomy; 68 patients had Outerbridge grade IV osteoarthritis and were examined in this study. The mean age of the 68 patients was 63.3 years (range, 51 to 77). The study was comprised of 5 males (7.3%) and 63 females (92.7%). The mean follow-up period was 52 months (range, 37-83 months). Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, and telephone interviews. Assessment included visual analog pain scale (VAS) scores, Lysholm scores, and whether further surgery was required (e.g., total knee arthroplasty or high tibial osteotomy). Results: Of the study population, 17 (25%) patients showed Outerbridge grade IV changes on the femoral condyle, 24 (35%) on the tibial condyle, and 27 (40%) on both the tibial and femoral condyle. The mean VAS decreased from 7.1 presurgery to 2.9 postsurgery (P < .05), and the mean Lysholm score increased from 65.7 presurgery to 82.9 postsurgery (P < .05). Four patients underwent further surgery, which was a total knee arthroplasty in all cases. The mean time to further surgery was 49.8 months (range, 20-75 months). Conclusions: Meniscal tear symptoms in patients with grade IV osteoarthritis can be improved using arthroscopic medial meniscectomy. Level of Evidence: Level IV, therapeutic case series.