Abstract
Purpose
To assess the distal femoral cartilage after unilateral arthroscopic partial meniscectomy and to explore the relationship between cartilage thickness and various disease-/surgery-related parameters.
Methods
Eighty-nine patients (42 M, 47 F) who had undergone arthroscopic partial meniscectomy surgery were evaluated. Ultrasonographic distal femoral cartilage thicknesses were measured with a 5–13-MHz linear probe (General Electric, Logiq P5) on mid-points of the lateral condyle, intercondylar notch and medial condyle of operated and non-operated knees by a physician blinded to patients’ data. Demographic features, duration after surgery, type of meniscal tear and site of meniscectomy were recorded.
Results
Mean age of the patients was 51.8 ± 12.8 years (range 18–88). Mean body mass index was 29.4 ± 4.4 kg/m2 (range 18–38). Overall, in patients with degenerative meniscal tears, femoral cartilage thicknesses pertaining to all the three measured sites (lateral, intercondylar and medial) were found to be decreased in the operated knees when compared with those of the non-operated knees (p = 0.004, p = 0.003, p = 0.041, respectively), whereas in patients with non-degenerative tears, this decrease was significant only in the intercondylar area (p = 0.038). When patients were grouped according to the duration (months) after their surgery (≤36, 37–48 and ≥49), cartilage thickness was similar between both knees in the first group, decreased at the lateral condyle (p = 0.008) and intercondylar area (p = 0.049) in the second group and decreased at all three sites (lateral, intercondylar and medial) in the third group (p = 0.015, p = 0.005 and p = 0.008, respectively).
Conclusion
These findings would be considered as unfavourable with respect to weight-bearing, and thus, conservative measures to support relevant joints would strongly be kept in mind during clinical practice. Lastly, ultrasonography may be a convenient alternative imaging method for the evaluation of short- and medium-term cartilage loss in patients with arthroscopic partial meniscectomy.
Levels of evidence
III.
Similar content being viewed by others
References
Adams JG, McAlindon T, Dimasi M, Carey J, Eustace S (1999) Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis. Clin Radiol 54:502–506
Akalın Y, Ozcelik A, Kose N, Seber S (2011) Rotational alignment of the lower extremity in adults: no relationship with osteoarthritis of the knee was proved. Eklem Hastalik Cerrahisi 22(2):75–80
Akizuki S, Mow VC, Müller F, Pita JC, Howell DS, Manicourt DH (1986) Tensile properties of human knee joint cartilage: I. Influence of ionic conditions, weight bearing and fibrillation on the tensile modulus. J Orthop Res 4:379–392
Akkaya S, Akkaya N, Kiter E, Kilic A, Ardic F (2012) Functional status, patient satisfaction and quality of life in patients with arthroscopic partial meniscectomy. Eklem Hastalik Cerrahisi 23(1):9–14
Andriacchi TP, Briant PL, Bevill SL, Koo S (2006) Rotational changes at the knee after ACL injury cause cartilage thinning. Clin Orthop Rel Res 442:39–44
Appleyard RC, Burkhardt D, Ghosh P, Read R, Cake M, Swain MV, Murrell GA (2003) Topographical analysis of the structural, biochemical and dynamic biomechanical properties of cartilage in an ovine model of osteoarthritis. Osteoarthritis Cartilage 11(1):65–77
Bin SI, Lee SH, Kim CW, Kim TH, Lee DH (2008) Results of arthroscopic medial meniscectomy in patients with grade IV osteoarthritis of the medial compartment. Arthroscopy 24(3):264–268
Burstein D, Gray ML (2006) Is MRI fulfilling its promise for molecular imaging of cartilage in arthritis? Osteoarthritis Cartilage 14:1087–1090
Castriota-Scanderberg A, De Micheli V, Scarale MG, Bonetti MG, Cammisa M (1996) Precision of sonographic measurement of articular cartilage: inter- and intraobserver analysis. Skeletal Radiol 25:545–549
Chatain F, Adeleine P, Chambat P, Neyret P, Société Française d’Arthroscopie (2003) A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 19(8):842–849
Eberhardt AW, Lewis JL, Keer LM (1991) Contact layered elastic spheres as a model of joint contact: effect of tangential load and friction. ASME J Biomech Eng 113:107–108
Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis, a sixteen-year followup of meniscectomy with matched controls. Arthritis Rheum 48:2178–2187
Englund M, Lohmander LS (2004) Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum 50(9):2811–2819
Hunter DJ, Zhang YQ, Niu JB, Tu X, Amin S, Clancy M, Guermazi A, Grigorian M, Gale D, Felson DT (2006) The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis. Arthritis Rheum 54(3):795–801
Lee CL, Huang MH, Chai CY, Chen CH, Su JY, Tien YC (2008) The validity of in vivo ultrasonographic grading of osteoarthritic femoral condylar cartilage: a comparison with in vitro ultrasonographic and histologic gradings. Osteoarthritis Cartilage 16(3):352–358
Martel W, Adler RS, Chan K, Niklason L, Helvie MA, Jonsson K (1991) Overview: new methods in imaging osteoarthritis. J Rheumatol Suppl 18:32–37
Mathiesen O, Konradsen L, Torp-Pedersen S, Jorgensen U (2004) Ultrasonography and articular cartilage defects in the knee: an in vitro evaluation of the accuracy of cartilage thickness and defect size assessment. Knee Surg Sports Traumatol Arthrosc 12:440–443
Mazzuca A, Brandt KD, Katz BP (1997) Is conventional radiography suitable for evaluation of a disease-modifying drug in patients with knee osteoarthritis? Osteoarthritis Cartilage 5:217–226
Messner K, Fahlgren A, Persliden J, Andersson BM (2001) Radiographic joint space narrowing and histologic changes in a rabbit meniscectomy model of early knee osteoarthrosis. Am J Sports Med 29(2):151–160
Möller I, Bong D, Naredo E, Filippucci E, Carrasco I, Moragues C, Iagnocco A (2008) Ultrasound in the study and monitoring of osteoarthritis. Osteoarthritis Cartilage 16:4–7
Naredo E, Acebes C, Möller I, Canillas F, de Agustin JJ, deMiguel E, Filippucci E, Lagnocco A, Moragues C et al (2009) Ultrasound validity in the measurement of knee cartilage thickness. Ann Rheum Dis 68:1322–1327
Oneto JM, Ellermann J, LaPrade RF (2010) Longitudinal evaluation of cartilage repair tissue after microfracture using T2-mapping: a case report with arthroscopic and MRI correlation. Knee Surg Sports Traumatol Arthrosc 18(11):1545–1550
Outerbridge RE (1961) The etiology of chondromalacia patellae. J Bone Joint Surg Br 43-B:752–757
Pearse EO, Craig DM (2003) Partial meniscectomy in the presence of severe osteoarthritis does not hasten the symptomatic progression of osteoarthritis. Arthroscopy 19(9):963–968
Peña E, Calvo B, Martínez MA, Doblaré M (2008) Computer simulation of damage on distal femoral articular cartilage after meniscectomies. Comput Biol Med 38(1):69–81
Petty CA, Lubowitz JH (2011) Does arthroscopic partial meniscectomy result in knee osteoarthritis? A systematic review with a minimum of 8 years’ follow-up. Arthroscopy 27(3):419–424
Prové S, Charrois O, Dekeuwer P, Fallet L, Beaufils P (2004) Comparison of the medial femorotibial joint space before and immediately after meniscectomy. Rev Chir Orthop Reparatrice Appar Mot 90(7):636–642
Roos H, Laurén M, Adalberth T, Roos EM, Jonsson K, Lohmander LS (1998) Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls. Arthritis Rheum 41(4):687–693
Setton LA, Mow VC, Howell DS (1995) Mechanical behaviour of articular cartilage in shear is altered by transection on the anterior cruciate ligament. J Orthop Res 13:473–482
Tanamas S, Hanna FS, Cicuttini FM, Wluka AE, Berry P, Urquhart DM (2009) Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum 61(4):459–467
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
Toyras J, Nieminen HJ, Laasanen MS, Nieminen MT, Korhonen RK, Rieppo J, Hirvonen J, Helminen HJ, Jurvelin JS (2002) Ultrasonic characterization of articular cartilage. Biorheology 39:161–169
Acknowledgments
The present study was supported by Pamukkale University Scientific Research Fund (Project No. 2010 BSP-19).
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Akkaya, S., Akkaya, N., Ozcakar, L. et al. Ultrasonographic evaluation of the femoral cartilage thickness after unilateral arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc 21, 1104–1110 (2013). https://doi.org/10.1007/s00167-012-2081-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-012-2081-8