This retrospective cohort study examines long-term outcomes in 99 patients at mean 17.5-year follow-up after meniscectomy. Clinical history, physical examination, weight-bearing radiographs, and electrogoniometric gait analysis were used to identify which preoperative and operative factors predict late results. The contralateral unoperated knee served as an internal control.
Before this paper, meniscectomy was widely regarded as a safe, low-morbidity procedure — prior series reported 60-90% satisfactory results, reinforcing a culture of liberal resection for any symptomatic meniscal tear.
Johnson et al. Used a deliberately stringent outcome scale and compared every operated knee to the patient's own contralateral knee, eliminating the optimistic bias of earlier uncontrolled series. The result: most patients fared poorly over two decades.
The practical takeaways are direct. Operate sooner rather than later. Each additional year of symptoms before meniscectomy shifts the outcome toward failure. When you do operate, complete the resection: leaving the posterior horn behind worsened every single knee in which it was done. Lateral meniscectomy carries higher risk than medial; removing both menisci is the worst option of all.
This paper is foundational to why modern sports medicine defaults to meniscus repair over resection whenever the tear pattern and vascularity allow. It directly preceded and conceptually enabled Roos et al. (1998) and Englund et al. (2003), which quantified the OA risk further. And it remains the reason every resident learns that the meniscus should be removed only when it is definitely abnormal.
This retrospective cohort study examines long-term outcomes in 99 patients at mean 17.5-year follow-up after meniscectomy. Clinical history, physical examination, weight-bearing radiographs, and electrogoniometric gait analysis were used to identify which preoperative and operative factors predict late results. The contralateral unoperated knee served as an internal control.
Before this paper, meniscectomy was widely regarded as a safe, low-morbidity procedure — prior series reported 60-90% satisfactory results, reinforcing a culture of liberal resection for any symptomatic meniscal tear.
Johnson et al. Used a deliberately stringent outcome scale and compared every operated knee to the patient's own contralateral knee, eliminating the optimistic bias of earlier uncontrolled series. The result: most patients fared poorly over two decades.
The practical takeaways are direct. Operate sooner rather than later. Each additional year of symptoms before meniscectomy shifts the outcome toward failure. When you do operate, complete the resection: leaving the posterior horn behind worsened every single knee in which it was done. Lateral meniscectomy carries higher risk than medial; removing both menisci is the worst option of all.
This paper is foundational to why modern sports medicine defaults to meniscus repair over resection whenever the tear pattern and vascularity allow. It directly preceded and conceptually enabled Roos et al. (1998) and Englund et al. (2003), which quantified the OA risk further. And it remains the reason every resident learns that the meniscus should be removed only when it is definitely abnormal.