2015 ISAKOS Biennial Congress ePoster #1616
Patellofemoral OA Changes Following Knee Meniscectomy 40 Years Post Operatively
Ioannis Pengas, MBChB, MRCS, MPhil, MD, FRCS (T&O), Truro, Cornwall UNITED KINGDOM
William Nash, MBBS BEng MRCS, London, - None - UNITED KINGDOM
Angelos Assiotis, SHO, London UNITED KINGDOM
Julian Hatcher, MCSP FOM CSCS, Manchester UNITED KINGDOM
Joanne Banks, FRCS (T&O), Liverpool UNITED KINGDOM
Michael J. McNicholas, BSc, MD, FRCS Tr & Orth, Manchester, Lancashire UNITED KINGDOM
Tayside University Hospitals, Tayside, UNITED KINGDOM
FDA Status Not Applicable
Summary: knee meniscectomy results in PFJ OA
Most of knee OA and meniscectomy studies concentrate on changes of the tibiofemoral joint whilst ignoring the patellofemoral joint (PFJ).
This study aims in assessing the long term effects of total meniscectomy on the patellofemoral joint.
Materials & Methods:
Twenty-two patients with otherwise pristine knees (no other intra-articular pathology recorded at the time of meniscectomy) who had their procedure under the auspices of a single surgeon were evaluated at a mean of 40 years post operatively via standardised weight-bearing radiographs.
PFJ OA was defined as presence of osteophytes and progression as joint space narrowing (JS <5mm). Correlations between PFJ OA and TFJ OA, IKDC score and range of movement (ROM) were examined.
The data were analysed with SPSS 17.0 (SPSS Inc., Chicago) statistical package where a p value of less than 0.05 was deemed to be statistically significant and examined for normality using the Shapiro-Wilk test. Parametric data was analysed with paired t-test whilst for non-parametric data the Wilcoxon signed-rank and the Mann-Whitney U test were used. Correlations were scrutinised with the Kendall’s tau coefficient.
A significant difference between the index and non-index knees in terms of osteophyte formation and JSN was observed. There was a significant difference (p<0.05) in ROM, tibiofemoral radiographic OA scores (Ahlback and Kellgren-Lawrence) and IKDC scores between knees with JS<5mm and JS>5mm at the lateral facet of the PFJ.
An association between PFJ OA and open total meniscectomy is confirmed. Explanations include the altered biomechanic loading patterns following meniscectomy as well as activation of protease cascades which act globally within the knee following the initial injury or tibiofemoral OA changes.