Summary
A decrease in the indications of arthroscopic surgery on degenerative tears has been found in the last 20 years.
Abstract
Aim
To analyze the evolution in the indications of arthroscopic surgery on degenerative meniscal tears in the last 20 years.
Hypothesis
A decrease in the indication of surgical treatment on degenerative meniscal tears would be found in the last 20 years.
Material And Methods
A large database of arthroscopically operated meniscal tears in the last 20 years was reviewed to analyze the characteristics of each meniscal tear: sex, age, knee and meniscus affected were recorded. Furthermore, the morphology, the location on the axial plane and the vascularization of the tear were registered. The tissue quality, namely the presence of degenerative tissue, was addressed. The moment of the surgery, stratified in 4 groups (2002-2006, 2007-20011, 2012-2016 and 2017-2021), and the characteristics of the meniscal tears were compared according to it and to the presence of degenerative tissue on the meniscal tear. Student’s T and ANOVA tests were used to compare means. Categorical data were represented in contingency tables and compared using the ?2 test for significance of differences. Statistical significant differences were set at p<0.05.
Results
1892 records met the criteria for inclusion. A 26.6% of the meniscal tears presented degenerative tissue; however, a decrease was found from a 63.2% in 2002-2006 to a 9,7% (p<0.001) in 2017-2021. The decrease was higher in medial meniscus (58.1 vs 44.2%; p<0.001), in females (61.1 vs 51,2%; p<0.001), in patients older than 45 years (48.5%; p<0.001). Longitudinal tears were the type of tear that experimented the highest decrease in the presence of degenerative tissue (63.6%; p<0.001). There was no difference according to the leg affected.
Conclusion
A significant decrease in the indication of arthroscopic surgery on degenerative tears has been found in the last 20 years. This data may encourage other surgeons to insist on diminishing their indications.