[Arthroscopic meniscus resection and open meniscectomy--a comparative study].

In a clinical follow-up study the postoperative results after arthroscopic meniscectomies are compared to conventional arthrotomies. 200 selected patients, half treated arthroscopically and half by open meniscectomy are reviewed after a postoperative period of 1.5-4 years. Each patient in the arthrotomy-group is matched with a patient in the endoscopic collective by age, sex and type of meniscus lesion. Ligamentous instability was an excluding criteria. The mean hospital stay in the arthroscopic group is 4.9 days compared to 12.3 days in the arthrotomy-group. At follow-up 46% of the arthroscopically treated patients are free of symptoms, in 49% the operation resulted in a significant relief of symptoms, whereas 5% have unsatisfactory results. In the arthrotomy-group 38% have excellent, 54% good and 8% unsatisfactory results. The total amounts of remission with 95% and 91.5% in both collectives are comparable. Using a modified Larson-scoring-scale to record the symptomatic results in the longer term we found a mean score of 91.3 points in the arthroscopic and of 89.4 points in the arthrotomy-group. Apart from the operative technique a partial meniscectomy results in a mean score of 91.9 points compared to 88.5 points at total meniscectomies. The presence of degenerative changes seems to influence the postoperative result negatively. The advantages of endoscopic surgery include a decreased hospitalisation and a shorter sick leave, whereas the long-term results do not differ significantly from conventional menisectomy. Referring to the progress of degenerative changes a partial meniscectomy should be preferred to a total meniscectomy to prevent the cartilage from degeneration and arthrosis.