Osteoarthritis after Meniscus Surgery: What do the X-Rays Tell Us?
Current research has shown that patients undergoing joint surgery may be at increased risk for developing joint osteoarthritis (OA) within the following decade. This type of OA is commonly referred to as post traumatic osteoarthritis. The true mechanism of this increased risk is currently unknown, but has lead researchers to postulate that changes in the intraarticular environment may contribute to the increased risk. However, identifying patients who are at higher risk for developing post traumatic OA is important for optimizing patient care and evaluating the best treatment protocol for each patient.
A group of researchers recently completed a clinical study examining progression of knee osteoarthritis (OA) following meniscus surgery. The study consisted of fifty-seven patients (38 male, 19 female) and analyzed the prevalence and progression of knee OA on X ray (compared to the opposite knee) following arthroscopic partial meniscectomy surgery, a procedure performed to remove damaged portions of the knee meniscus. The follow-up time ranged from 5-12 years post-surgery (mean 8.1 years).
Patients were organized according to body mass index (BMI), meniscus injury type (degenerative vs. traumatic), and location of meniscectomy. The results of the study stated that the prevalence of knee OA was 62.69% in the compartment between the thigh bone and weight-bearing leg bone (tibiofemoral compartment). The study also illustrated a clinically significant progression of joint OA following meniscus surgery, and showed results based on different compartments in the knee joint:
- Medial Compartment: 17.2% before surgery to 65.95% after surgery
- Lateral Compartment: 17.64% before surgery to 58.82% after surgery
- Patellofemoral Compartment (below the knee-cap): 5.2% before surgery to 42.10% after surgery
Furthermore, the study showed OA progression to be higher in the obese group and in patients with degenerative meniscal tears. Statistical analysis validated a significant correlation between x-ray image findings and clinical results. The study concluded that patients in the obese, overweight, and degenerative tear group were more susceptible to OA in the tibiofemoral and patellofemoral (below the knee-cap) compartments of the knee after meniscectomy.
Although further research is needed to analyze specific risk factors for the development of post traumatic OA, this study adds to the growing volume of literature in this area. In addition, as our understanding of the mechanisms of joint osteoarthritis expand, the possibility of identifying new targets for minimally invasive disease management also grows.
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