Osteoarthritic changes after excision of injured meniscus of the knee without joint space narrowing in patients older than forty.
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概要
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Osteoarthritic changes were evaluated on 11 knees in 11 patients who had, after the age of 40, a total excision of injured meniscus of the knee without there being any joint space narrowing (less than 3 mm) in a standing antero-posterior radiogram. This series included 9 lateral menisci and 2 medial excisions in 4 men and 7 women, whose ages at operation ranged from 40 to 63 years with an average of 49 years. The average follow-up period was 5 years and 7 months after operation, with a range of from 1 year to 11 years and 1 month.<BR>At the time of the follow-up, in 10 knees out of 11, the knee function scores using the criteria of the Japanese Society of the Knee (the second tentative one) were more than 80 points. The standing femoro-tibial angle (FTA) of 8 knees with lateral meniscus injury showed no difference before and after meniscectomy. In 2 knees with medial meniscus injury, each standing FTA of the involved side increased by 3 and 4 degrees, but there was no difference between the standing FTA of the involved side and of the uninvolved side. At the time of the follow-up, the joint space of 7 knees in a standing radiogram revealed no change, and the joint space of the other 3 knees became a little thinner, but not less than 3 mm. No medial and lateral instability was caused by total meniscectomy. It is considered, though, that severe osteoarthritic changes indicated for operation (high tibial osteotomy, total knee replacement etc.) may develop in rare cases after total meniscectomy even in patients older than forty.
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