Arthroscopic repair is a viable option for patients over age 50 with a meniscal root tear and is less likely to lead to total knee arthroplasty (TKA) than observation only, according to research presented at the 2019 American Orthopedic Society of Sports Medicine Annual Meeting.
Meniscal root tears affect both young, healthy athletes and older patients with early degeneration in their knees. Root tears lead to de-tensioning of the meniscus and have been associated with increased contact forces and cartilage damage. Management of older patients with root tears is controversial, and the efficacy of different treatment options is unclear.
Led by Jason L. Dragoo, MD, researchers from Stanford Medicine in Redwood City, California, evaluated clinical outcomes in 48 patients over age 50 who were diagnosed with a posterior meniscal root tear between 2006 and 2015. Patients were divided into 2 groups:
- All-inside arthroscopic repair technique (n=30)
- Observation only (n=18)
The primary outcome measures were changes in KOOS subscores (Symptoms, Pain, Activities of Daily Living, Sports and Rec, and Quality of Life) and the Lysholm, Tegner, and VR12 PCS questionnaires from baseline to minimum follow-up of 2 years.
The researchers found that patients in the arthroscopic repair group had significant improvement in all clinical outcomes scores. Patients in the observation group had some improvements, but they were only significant for the KOOS Pain, KOOS Activities of Daily Living, and VR12 PCS. In addition, 3.3% of patients who had undergone arthroscopic repair required TKA, compared with 33.3% of patients in the observation group.
“Our study found a significant improvement in all clinical outcome scores in the surgery group at 2-year follow-up,” Dr. Dragoo said. “Surgical management showed higher functional outcomes and decreased TKA conversion rates as compared to observation and should be considered as a treatment option for the treatment of meniscal root tears in the older population,” he said.
Click here to access the abstract from this presentation.
Dragoo JL. Outcomes of Arthroscopic Repair versus Observation in Older Patients (Paper 02). Presented at the 2019 Annual Meeting of the American Orthopedic Society of Sports Medicine, July 11-14, 2019, Boston, Massachusetts.