Is there an association between articular cartilage changes and degenerative meniscus tears?

PURPOSE: The objective of the present study was to evaluate whether horizontal cleavage and complex meniscus tears, which are degenerative tears, are associated with an increased incidence of cartilage damage, in comparison with patients having other patterns of meniscal injury.

TYPE OF STUDY: Case series study.

METHODS

Data were collected prospectively from 497 consecutive knee arthroscopies carried out from 1997 to 2001. Patient data (age, sex, duration of symptoms, injuries, and possible mechanism of injury), operative details (types and number of portals, equipment used), intra-articular findings (articular, meniscal and synovial lesions, and stability characteristics), and procedures performed were recorded. Articular lesions were noted on anatomic articular maps of the different functional zones using a system that presaged the current Internal Cartilage Repair Society system.

RESULTS

A comparison of patients with horizontal cleavage and complex meniscal tears to patients with other types of meniscal tear showed for the former (1) increased incidence of chondral lesions (88.4% v 69.6%, respectively, P < .001), (2) increased severity--type III and IV Outerbridge classification--of chondral lesions (52.8% v 29.4%, respectively, P < .001), and (3) increased incidence of patients having more than 1 chondral lesion (65.3% v 33%, respectively, P < .001).

CONCLUSIONS

Complex and horizontal cleavage meniscal tears are highly associated with an increased incidence and severity of cartilage degeneration compared with other types of meniscal tears. Degenerative meniscus tears are not as benign as was previously thought. New age-related categories of chondral damage are emerging.

LEVEL OF EVIDENCE: Level IV, case series prognostic study.