Arthroscopic meniscectomy in the anterior cruciate ligament-deficient knee

Abstract

Patients with injury to the anterior cruciate ligament (ACL) frequently develop tears of the menisci. Removal of the meniscus, while relieving some complaints, may increase the patient's instability. To evaluate our success and quantify the reasons for failure, we evaluated 48 patients who underwent arthroscopic partial meniscectomy from 1979 to 1982. Patients were evaluated as to their subjective complaints, scored on a 100-point knee evaluation, and evaluated with standing x-rays. In addition, measurement using the KT-1000 knee arthrometer was made to assess the degree of tibial translation. Follow-up averaged 32 months, with a range of 24-50. At followup, 29 patients (60%) were judged to be clinical successes with resolution of their complaints and no aggravation of their instability. Nineteen patients (40%) were judged to be clinical failures in that their complaints persisted (14 patients) or ACL reconstruction was required (5 patients). Eight patients noted some increase in their instability, and three required a repeat meniscectomy. Arthroscopic partial meniscectomy can be a useful procedure in some patients with injury to the ACL. Patients more likely to do well are those with a torn medial meniscus with a chief complaint of locking. Examination would demonstrate a mild pivot shift, absence of generalized ligamentous laxity, and an anterior tibial translation difference of less than 5 mm.