Early Functional Outcome Of Patients With Isolated Meniscal Injury Treated By Arthroscopic Partial Meniscectomy At Muhimbili Orthopedic Institute

Abstract

ABSTRACT Background Meniscus injury is the common problem occurring due to several causes, and its treatment has evolved from open meniscectomy, arthroscopic total meniscectomy and now arthroscopic partial meniscectomy (or repair) being commonly performed. Currently at MOI, there is increase in the number of patients operated by arthroscopic partial meniscectomy compared to previous time and its outcome is not yet established. Objectives: Early functional outcome of patients with isolated meniscal injury treated by arthroscopic partial meniscectomy at Muhimbili orthopedic institute (MOI) were determined. Materials and Methods: A prospective hospital based descriptive study involving adult patients with meniscal injury treated by arthroscopic partial meniscectomy, was conducted at MOI for a period of twelvemonths from June 2016 to May 2017. 50 patients met inclusion criteria and were all enrolled for the study. The patients were assessed and scored using Lysholm knee functional score (LFKSS) before treatment, then 2nd, 6th and 12th weeks post treatment. Data was collected with the help of research assistant guided by structured questionnaire and tool like Goniometer was used to accomplish data collection. Outcome was assessed using Lysholm scores with eight domains at 2nd ,6th and 12th weeks. At 12th week the scores were compared with that before treatment. The data obtained were analyzed using SPSS version 20. Results A total of 50 patients with isolated meniscal injury were enrolled at MOI from May 2016 to December 2016 and were all followed up for 12 weeks each. 5 patients lost to follow up, only 45patients were analyzed at 12th week. Among 45 patients, 28 (62.2%) were male and 17(37.8%) were female with male to female ratio of 2:1; more than half 29 (64.4%) were below 40years and 16 (35.6%) were above 40years. Majority 26(57.8%) were treated 3months and above, and 19(42.2%) less than 3monthsfrom injury. Activity of daily living accounted 18(40%), Sports 13(28.9%), Road traffic accidents10 (22.2%), Falling from height3 (6.7%) and others 1(2.2%). The median Lysholm score was 63±13.61SD before treatment and 100± 6.38SDat twelfth week post treatment (p value=0.0001), and mean flexion angle was 108.53±10.83˚ and 136.55±5.88˚ degrees at twelfth weeks pre and post treatment respectively (p value =0.0001). Functional outcome at twelve weeks postoperatively assessed and graded by Lysholm functional knee score (LFKS) was Excellent for 39(86.7%) and 3 (6.7%) attained good results and poor to fair results were seen only on 3(6.7%) patients. Outcome not affected by age (p=0.99), sex (p=0.235) or duration of symptoms (p=0.281) post injury at 12th week. Conclusion Meniscal injury is more common in males, and majority due to activity of daily living. At our set up, Arthroscopic partial meniscectomy showed excellent to good results (outcome) as most of our patients attained their pre injury state at 12th weeks with full knee function. Recommendation meniscal injury has excellent to good outcome despite of delay in treatment, so operation should alsobe considered even in delayed clinical presentation; and larger, prospective studies are needed to further explore these findings.