Medial meniscectomy in XXXX over the age of fifty: a six year follow-up study.

@entity1 @entity179 @entity8221 @entity937
PURPOSE: Meniscectomy in the older @entity1 remains a controversial topic. The aim of our study is to assess the mid-term outcome of arthroscopic partial medial meniscectomy in @entity1 over fifty years of age and attempt to retrospectively identify symptoms and/or findings on examination which can differentiate between non-degenerative medial @entity937 versus @entity179 . MATERIALS AND METHODS: Thirty-two @entity1 over the age of fifty who had undergone arthroscopic medial partial meniscectomy, were reviewed. The average age was 60 (51-74 yrs) and the average follow-up was six years (3-7 yrs). Based upon the intra-operative findings, @entity1 were divided into two groups: (1) @entity179 ( @entity179 ; n = 12) and (2) @entity179 ( @entity179 ; n = 20). Our outcome measurements were with the @entity8221 knee score, a satisfaction score, and weight-bearing X-rays. RESULTS: In the @entity179 group, eleven @entity1 were rated excellent or good, and one was rated poor. In the @entity179 group, three @entity1 were rated as excellent or good, eight as fair, and nine as poor. The @entity8221 score was 97 +/- 4.6 for the @entity179 group and 85 +/- 9.5 for the @entity179 group. The average satisfaction score was 9.2 +/- 0.7 (very satisfied) for the @entity179 group and 5.8 +/- 2.6 (fairly satisfied) for the @entity179 group. There was no significant difference between the @entity179 and the @entity179 groups with regards to pre-operative symptoms and signs, except for the McMurray sign, which was found to be positive in 83% of @entity179 cases versus 25% of @entity179 cases (sensitivity = 83%). Using only these data, the McMurray sign was 67% specific for @entity179 . CONCLUSIONS: Arthroscopic medial meniscectomy in older @entity1 provides 90% good results six years after a non-degenerative @entity937 , but only 20% of good results after a degenerative @entity937 . However, based on this study, neither symptoms nor physical examination are able to differentiate between traumatic @entity937 and @entity179 in older @entity1 . A positive McMurray's sign favors the diagnosis of a traumatic tear. However, a specificity of this test of only 67% as shown in our data questions its utility in clinical decision-making.
