Increased risk for knee replacement surgery after arthroscopic surgery for degenerative meniscal tears: a multi-center longitudinal observational study using data from the osteoarthritis initiative

• Published in: Osteoarthritis and cartilage Vol. 25; no. 1; pp. 23 - 29
• Main Authors: Rongen, Jan J, Rovers, Maroeska M, van Tienen, Tony G, Buma, Pieter, Hannink, Gerjon
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2017
• Subjects: Aged; Arthroplasty; Arthroplasty, Replacement, Knee - statistics & numerical data; Arthroscopy - adverse effects; Arthroscopy - statistics & numerical data; Female; Humans; Knee Injuries - complications; Knee Injuries - surgery; Knee replacement; Longitudinal Studies; Male; Meniscectomy; Meniscectomy - adverse effects; Meniscectomy - statistics & numerical data; Meniscus; Meniscus - injuries; Meniscus - surgery; Middle Aged; Osteoarthritis; Osteoarthritis, Knee - surgery; Rheumatology; Risk Factors; knee replacement; meniscectomy; arhtroplasty; Osteoarthritis; meniscus; Arthroplasty; Meniscus; Meniscectomy; Knee replacement
• ISSN: 1063-4584; 1522-9653
• DOI: 10.1016/j.joca.2016.09.013

Summary Objective The primary objective was to assess whether patients with knee osteoarthritis and whom undergo arthroscopic meniscectomy have an increased risk for future knee replacement surgery. Design Data used were obtained from the Osteoarthritis Initiative (OAI) study. Setting Participants were enrolled, in four clinical centers, between February 2004 and May 2006 and were followed up on an annual basis up to and including 108-months from enrollment. Participants 4674 participants (58.4% female), aged 45-79, of all ethnic groups, who had, and those who were at high risk for developing, symptomatic knee osteoarthritis were included, of which 3337 (71.4%) were included in the final follow up visit. Main outcome measures Hazard ratio of knee replacement surgery for participants who underwent arthroscopic meniscectomy during follow up compared to propensity score matched participants who did not undergo arthroscopic meniscectomy during follow up. Results 335 participants underwent arthroscopic meniscectomy during follow up, of which 63 (18.8%) underwent knee replacement surgery in the same knee. Of the 335 propensity score matched participants 38 (11.1%) underwent knee replacement surgery during follow up. Results from the Cox-proportional hazards model demonstrated that the hazard ratio of knee replacement surgery was 3.03 (95%CI (1.67 tot 5.26)) for participants who underwent arthroscopic meniscectomy relative to the propensity score matched participants who did not undergo arthroscopic meniscectomy. Conclusions In patients with knee osteoarthritis arthroscopic knee surgery with meniscectomy is associated with a 3 fold increase in the risk for future knee replacement surgery.