PARTIAL ARTHROSCOPIC MENISCECTOMY VERSUS TOTAL OPEN MENISCECTOMY

One hundred sixteen patients who had undergone partial arthroscopic meniscectomy were reviewed in a short-term follow-up study (mean follow-up; 16 months). Their results were compared with those of a group of 402 patients who had been treated previously by conventional open meniscectomy in the same hospital. Average age in the arthroscopic group was 40 years, in the open group 34. Average sick leave was 4 weeks in the arthroscopic group, 10 weeks in the arthrotomy group. In the endoscopic group, there was virtually no sick leave for self-employed people, but 7 weeks if the lesion was sustained at work. Top-class sportsmen resumed competition 5 weeks after arthroscopy, 8 weeks after conventional meniscectomy. Still, most of them complained of prolonged synovial reaction resulting in a period of poor physical condition and performance. Of the patients treated by arthroscopy, 7.5% presented minor problems related to the approach (anteromedial-transpatellar), while 21.5% had similar problems after routine anteromedial incision in the open meniscectomy group. The overall results after arthroscopy were excellent in 49 cases (41.5%), good in 51 (43%), fair in 14 (12%), and poor in four (3.5%). These short-term results are comparable to those of the open meniscectomy group. The short-term results in the older patients confirm our belief that (partial) meniscectomy is useful for the older patient with a history of mechanical meniscal problems, with or without cartilage degeneration, provided one is not dealing with frank osteoarthrosis and secondary varus or valgus deformity.