Editorial Commentary: Arthroscopic Partial Meniscectomy Outcomes Are Worse in Patients With Concomitant Pathology

Abstract

Arthroscopic debridement for degenerative joint disease has not been shown to be beneficial, and initial nonoperative management is now recommended for degenerative meniscal tears. Indications for arthroscopic partial meniscectomy (APM) are traumatic tears with a clear history of mechanical symptoms, such as locking and catching, with joint-line pain or acute onset of symptoms that have failed nonsurgical treatment. Predictors of dissatisfaction with APM include female sex, obesity, and lateral meniscal tears. Beyond such demographic factors, concomitant joint pathology negatively affects outcomes of APM because a large majority of patients without radiographic osteoarthritis (OA) have evidence of concomitant tissue changes considered to be associated with OA including chondral damage, subchondral bone changes, signs of inflammation or ligament pathology. Particularly relevant seem to be chondral lesions radiologists would label as "delaminating," which are those a surgeon might call an "impending loose bodies." Cartilage repair surgery may be indicated in these cases.