A COMPARISON BETWEEN MEDIAL MENISCUS REPAIR, PARTIAL MENISCECTOMY, AND NORMAL MENISCUS IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTED KNEES

A clinical, radiographic, and scintigraphic comparative study was perf ormed on 57 consecutive successful patellar tendon anterior cruciate l igament reconstructions far chronic laxity. Patients were divided into 3 matched groups according to the medial meniscal treatment. Group A included 18 patients with medial meniscal repairs; Group B, 19 patient s with partial medial meniscectomies; and Group C, 20 patients with no rmal menisci (controls). The average followup was 55 months. At clinic al examination, patients in Group B had more activity-related pain tha n those in Group C (p = 0.04). The anteroposterior weight-bearing view s in extension showed more degenerative changes in the medial compartm ent in Group B than in the other 2 groups (Group A versus B, p = 0.01; Group C versus B, p < 0.001). Scintigraphy showed an increased uptake in the operated knee as compared with the normal side (11%), but no d ifferences among the 3 study groups. The patients with partial menisce ctomies had more pain and degenerative radiographically evident change s than the control group. Medial meniscal repair offers a better chanc e than partial meniscectomy to preserve the articular cartilage of the medial compartment. Bone homeostasis, as detected by bone scanning, r emains slightly altered in successful reconstructions as compared with the opposite normal side.