The arthroscopic classification of degenerative medial meniscus injury / 中华骨科杂志

ABSTRACT

Objective To explore the classification of degenerative medial meniscus injury under arthroscopy and its clinical significance.Methods This study involved 122 patients who underwent arthroscopic operation because of degenerative medial meniscus injury from January 2012 to December 2012,eliminating patients who received synovectomy for severe synovitis.There were 27 males and 95 females,with 63 left knees and 59 right knees.The average age was 61.8±8.9 years.The average BMI was 26.5±3.4 kg/m2,while the average preoperative Lysholm score was 47.2± 15.0.The cartilage injury was estimated by Outerbridge classification system during arthroscopic surgery.Both the difference of the preoperative Lysholm score and the number of articular surfaces with Ⅳ degree of cartilage injury were compared among different types of degenerative medial meniscus injury.Resuits The horizon tear of posterior horn group included 33 patients.The average number of articular surfaces with Ⅳ degree of cartilage injury was 1.24± 1.48 while the average preoperative Lysholm score was 52.5± 14.4 points,with pain score of 7.7±6.5.The root injury of posterior horn group included 16 patients,whose average number of articular surfaces with 1Ⅳ degree of cartilage injury was 1.13±1.26 and average preoperative Lysholm score was 37.5±8.4 points,with pain score of 3.1±4.0.The complex serious injury group included 73 patients.The average number of articular surfaces with Ⅳ degree of cartilage injury was 2.26±1.61 and the average preoperative Lysholm score was 46.9±15.3 points,with pain score of 6.8±5.4.Both the preoperative Lysholm score and pain score of the root injury of posterior horn group was significantly lower than that of the horizon tear and the complex serious injury group.The average number of articular surfaces with Ⅳ degree of cartilage injury between the root injury and the horizon tear of posterior horn group had no significant difference.The number of these two groups was less than the complex serious injury group,with statistically significant difference.Conclusion The arthroscopic classification of degenerative medial meniscus injury could be classified into three types.The degenerative cartilage injury of root injury of posterior horn and horizon tear of posterior horn is relatively mild,which are the early stages of joint degeneration.However,the clinical symptoms and disability caused by root injury of posterior horn are more severe.On the other hand,the degenerative cartilage injury of complex serious injury is relatively severe,which belongs to the late stage,while the clinical symptoms and disability are relatively mild.