[Partial meniscectomy via arthroscope in patients over 50 years old]. / Partiële meniscectomie per artroscoop bij patiënten boven de 50 jaar.

Between July 1983 and July 1986 115 patients, aged 50 years and older, suffering from 122 meniscal tears, were treated by arthroscopic surgery. Of these, 109 patients with 116 meniscectomy could be seen for a follow-up examination 2 years postoperatively. Patients of 50 years and older are known to need a long hospitalisation and a long rehabilitation period after an open meniscectomy. A quarter of all patients had a knee accident in their past as the cause of their complaints. Their main complaints are pain and swelling. As could be expected we found degenerative changes in 78% of the knees. After arthroscopic surgery the hospital stay is short, 75% is back home within 2 days. Half of the patients needed physiotherapy afterwards, 80% of all arthroscopically treated patients were satisfied. The group of patients aged 70 years and older scored worse, 50% of this group was satisfied. Two patients with severe degenerative changes on the X-rays did well. There is a positive correlation between the changes found arthroscopically and the final result.

Indications for arthroscopy in mon- and polyarticular arthritis.

In many cases clinical and laboratory data and x-rays are insufficient to diagnose the aetiology of synovitis in gonarthritis and to plan adequate treatment. The efficacy of arthroscopy in the management of the knee lesion was studied in mon- and polyarthritis. A classification of 'very useful', 'useful' and 'not useful' was used. On the basis of results reported here we outline the indications for arthroscopy in mon- and polyarthritis.

Arthroscopy in the evaluation of operative treatment of osteochondrosis dissecans.

In an early stage of postoperative evaluation of intra-articular surgery, as in osteochondrosis dissecans, arthroscopic examination is indispensable. In order to compare the results of different cases, a classification is necessary. The arthroscopic grading system presented is valuable for assessing degeneration of the three knee compartments. Early arthroscopic evaluation for follow-up can be used to classify postoperative complications that are not visable radiologically and are not severe enough to justify re-exploration. After follow-up examination with arthroscopy, advice to the patient may halt the progression of deterioration. Further study of the different treatments can help in formulating a plan of management of osteochondrosis dissecans.