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. 2022 Jul 26;11(15):4330.
doi: 10.3390/jcm11154330.

Macroscopic Synovial Inflammation Correlates with Symptoms and Cartilage Lesions in Patients Undergoing Arthroscopic Partial Meniscectomy: A Clinical Study

Eleonora Olivotto  1 , Giovanni Trisolino  2   3 , Elisa Belluzzi  4   5 , Antonello Lazzaro  5 , Alessandro Strazzari  2 , Assunta Pozzuoli  4   5 , Augusto Cigolotti  5 , Pietro Ruggieri  5 , Andrea Evangelista  6 , Francesca Ometto  7 , Stefano Stallone  3 , Steven R Goldring  8 , Mary B Goldring  8 , Roberta Ramonda  7 , Brunella Grigolo  1 , Marta Favero  7   9
Affiliations

Macroscopic Synovial Inflammation Correlates with Symptoms and Cartilage Lesions in Patients Undergoing Arthroscopic Partial Meniscectomy: A Clinical Study

Eleonora Olivotto et al. J Clin Med. .

Abstract

Background: The aim of the study was to examine the relationship among patients' characteristics, intraoperative pathology and pre/post-operative symptoms in a cohort of patients undergoing arthroscopic partial meniscectomy for symptomatic meniscal tears.

Methods: Clinical data were collected (age, sex, body mass index, time to surgery, trauma). Intraoperative cartilage pathology was assessed with Outerbridge score. Meniscal tears were graded with the ISAKOS classification. Synovial inflammation was scored using the Macro-score. Patient symptoms were assessed pre/post-operatively using the KOOS instrument.

Results: In the series of 109 patients (median age 47 years), 50% of the meniscal tears were traumatic; 85% of patients showed mild to moderate synovitis; 52 (47.7%) patients had multiple cartilage defects and 31 (28.4%) exhibited a single focal chondral lesion. Outerbridge scores significantly correlated with patient age, BMI and synovial inflammation. There was a correlation between severity of chondral pathology and high-grade synovial hyperplasia. Pre-operative KOOS correlated with BMI, meniscal degenerative changes and symptom duration. Obesity, time to surgery, presence of high-grade synovial hyperplasia and high-grade cartilage lesions were independent predictors of worse post-operative pain and function.

Conclusion: We demonstrated that pre-operative symptoms and post-operative outcomes correlate with synovitis severity and cartilage pathology, particularly in old and obese patients that underwent arthroscopic partial meniscectomy. Importantly, patients with a degenerative meniscal pattern and with longer time to surgery experienced more severe cartilage damage and, consequentially, pain and dysfunction. These findings are fundamental to identify patients suitable for earlier interventions.

Keywords: arthroscopic partial meniscectomy; cartilage degradation; macroscopic score; meniscal tear; osteoarthritis; post-operative outcomes; synovial inflammation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mean (95% CI) KOOS subscale changes during post-surgery follow-up in patients with high and low grade of suprapatellar synovial hyperplasia (≤2 vs. > 3) and cartilage lesions (≤2 vs. >2) (ADL = Function in daily living; QOL = Knee-related quality of life; CI = confidence interval).
See this image and copyright information in PMC

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