Short-Term Functional Outcome After Arthroscopic Partial Meniscectomy in Middle-Aged Patients with Meniscal Tear Treated at Muhimbili Orthopaedic Institute

Abstract

Background: Arthroscopic partial meniscectomy for middle-aged patients with meniscal tear is an effective procedure in relieving knee pain and improving functional outcome, however, the functional outcome has been shown to depend on gender, BMI and type of meniscal tear. The data of this study provides baseline information on the short term functional outcome after APM on middle-aged patients at MOI. Objective: The objective of the current study was to assess the short term functional outcome among middle-aged patients with meniscal tear after arthroscopic partial meniscectomy treated at MOI from May 2020 to December 2020. Methodology: A hospital-based descriptive cross-sectional study was conducted at Muhimbili Orthopaedic Institute from May 2020 to April 2021. 53 patients who met the inclusion and exclusion criteria were enrolled on the study and data was collected using a structured standard questionnaire. VAS score was used to assess pain and Lysholm Knee Functional Score was used to assess the functional outcome of the patients three months after APM. The data collected were analyzed using SPSS version 20 computer software. Categorical variables were summarized by using frequency tables in percentage and comparisons were done by using Fisher's exact test. Numerical variables were summarized by using means and standard deviation. Ethical clearance was obtained from the Institutional Review Board, the Muhimbili University of Health and Allied Sciences (IRB-MUHAS) and permission to carry out the study was sought from the MOI administration. Results; A total of 53 middle-aged patients with meniscal tear were enrolled in the study from May 2020 to December 2020 and 3 patients were lost to follow-up, only 50 patients were analysed at 12th-week post APM. Among 50 patients 16 (32%) were male and 34(68%) were female with a male to female ratio of 1:2, Majority of the patients were obese 22(44%) followed by overweight 16(32%) and normal weight 12(24%) and also the majority of the patients had degenerative meniscal tear 43 (86%) while 7 (14%) had a traumatic tear. There was a significant improvement in terms of pain between preoperative (VAS Score 7.26±1.17) vi and 12th week postoperative (VAS score 2.32±1.34) with P value<0.001 and also there was a significant improvement in functional outcome between preoperative (Lysholm knee scoring scale 48.88±11.08) and 12th week postoperative (80.04±11.63) with P value<0.001. The functional outcome score at 12th week was graded as 31 (62%) observed as excellent to good, 14 (28%) fair and 5 (10%) poor Lysholm knee functional score. Male had significantly improved better than female in terms of functional outcome (P value=0.008), but BMI groups (P value=0.205) and types of meniscal tear (P value=0.084) had no significant difference in terms of functional outcome at12th week postoperative. Conclusion; Meniscal tear in middle-aged patients affects women more than men. The degenerative meniscal tear was the most common aetiology of meniscal tear in middle-aged patients than a traumatic meniscal tear. Arthroscopic partial meniscectomy showed to have improved knee pain and functional outcome in the short term postoperative period. Male showed to have better improvement in terms of postoperative functional outcome than females while BMI groups and types of meniscal tear had no significant difference in postoperative functional outcome. Recommendations; Arthroscopic partial meniscectomy is an evolving procedure in our environment, so this procedure can be done in middle-aged patients with meniscal tears due to excellent to good results in the majority of patients as shown in this study. Long term outcome study or a comparative study with other treatment modalities is needed to know the long term effectiveness of APM in middle-aged patients with a meniscal tear.