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. 2021 Feb 10;9(2):2325967120981777.
doi: 10.1177/2325967120981777. eCollection 2021 Feb.

Risk Factors for Rapid Chondrolysis After Partial Lateral Meniscectomy: A Scoping Review of the Literature

Charles Pioger  1 , Adnan Saithna  2 , Vikram Kandhari  1 , Mathieu Thaunat  1 , Thais D Vieira  1 , Benjamin Freychet  1 , Florent Franck  1 , Bertrand Sonnery-Cottet  1
Affiliations

Risk Factors for Rapid Chondrolysis After Partial Lateral Meniscectomy: A Scoping Review of the Literature

Charles Pioger et al. Orthop J Sports Med. .

Abstract

Background: The occurrence of rapid chondrolysis after partial lateral meniscectomy is rare. The pathophysiology, risk factors, and outcomes of treatment have not been established.

Purpose: The primary aim of this study was to perform a scoping review of the literature to determine the potential risk factors and pathogenesis of rapid chondrolysis. The secondary objective was to report outcomes of treatment.

Study design: Systematic (scoping) review.

Methods: A scoping review of the literature was conducted in accordance with the framework of Arksey and O'Malley. A search strategy based on the terms "chondrolysis" AND "knee," "chondrolysis" AND "meniscus," and "chondral damage" AND "lateral meniscus" was applied to the PubMed database on March 31, 2020. All relevant studies were included. Patient demographics and clinical data were extracted from these studies and analyzed in order to investigate the potential risk factors, pathogenesis, and outcomes of treatment for rapid chondrolysis.

Results: Five articles (22 cases) featuring rapid chondrolysis in the lateral compartment after partial lateral meniscectomy were identified and included. The condition occurred most frequently in patients who were young (mean age, 25.6 years), male (20/22 cases; 91%), and participating in high-intensity sports (19/22 cases; 86.4%) within 1 year of the index procedure. Half of the included study population underwent surgery for a radial tear. All professional athletes (13/13) returned to the preinjury level of sport. All authors of included studies suggested that the main causal risk factor was mechanical focal cartilage overload in the lateral compartment of the knee.

Conclusion: Rapid chondrolysis after partial lateral meniscectomy is a rare condition that typically occurs within 12 months of the index procedure. Younger age, male sex, high-intensity sports participation, and some meniscal tear patterns (eg, radial tear) are potentially important risk factors. Return-to-sport rates at short-term follow up are high, but no long-term studies were identified. The pathogenesis of rapid chondrolysis seems to relate to mechanical focal cartilage overload.

Keywords: arthroscopy; knee; lateral meniscus; meniscectomy; rapid chondrolysis.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: B.S.-C. is a paid consultant for and receives royalties and research support from Arthrex. M.T. is a paid consultant for Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
(A) Clinical suspicion of rapid chondrolysis was raised because radiographs (Schuss views) demonstrated 30% narrowing of the lateral compartment joint space as compared with the left knee (lateral compartment joint space, 7.5 mm in the left knee and 5.3 mm in the right). (B) Furthermore, magnetic resonance images at the same time demonstrated evidence of previous lateral meniscectomy and effusion. The patient went on to have arthroscopic evaluation, which revealed (C, D) abundant loose cartilaginous debris, (E) Outerbridge grade 4 changes on the lateral femoral condyle, and (F) grade 3 changes on the lateral tibial plateau.
Figure 2.
Figure 2.
Flow diagram of identification, screening, and selection of studies.
See this image and copyright information in PMC

References

    1. Abdon P, Turner MS, Pettersson H, Lindstrand A, Stenström A, Swanson AJ. A long-term follow-up study of total meniscectomy in children. Clin Orthop Relat Res. 1990;257:166–170. - PubMed
    1. Alford JW, Lewis P, Kang RW, Cole BJ. Rapid progression of chondral disease in the lateral compartment of the knee following meniscectomy. Arthroscopy. 2005;21(12):1505–1509. - PubMed
    1. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
    1. Aune KT, Andrews JR, Dugas JR, Cain EL. Return to play after partial lateral meniscectomy in National Football League athletes. Am J Sports Med. 2014;42(8):1865–1872. - PubMed
    1. Bedi A, Kelly N, Baad M, et al. Dynamic contact mechanics of radial tears of the lateral meniscus: implications for treatment. Arthroscopy. 2012;28(3):372–381. - PubMed

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