Arthroscopic Partial Meniscectomy Using a Needle Arthroscope for Visualization Resulted in Greater Retention of Postoperative Quadriceps Muscle Strength Compared to Traditional Arthroscope.

Introduction: The purpose of this study is to prospectively evaluate differences in post-arthroscopic partial meniscectomy patients based upon the use of a small-bore needle arthroscope or traditional arthroscope for intraoperative visualization.

Materials and methods: Sixty-eight patients were randomized in a 1:1 fashion to have the visualization for arthroscopic partial meniscectomy performed with either a needle arthroscope or traditional arthroscope. Prior to surgery and one-week post procedure, patients underwent peak torque isometric knee extension testing using a handheld dynamometer and Visual Analog Scale (VAS) score collection. The intraoperative arthroscopic fluid volume used was collected. Exclusion criterion included: age under 18, non-English speaking, Kellen-Lawrence Grade 3 or higher, previous ipsilateral knee surgery within six months, and any patient in which arthroscopic partial meniscectomy (APM) was not considered the primary surgical procedure. Tourniquet was not utilized for either study group.

Results: Two group comparisons were performed between patients in the needle arthroscope (NA) group (n=34) and patients in the traditional arthroscope (TA) group (n=34). For the operated knee, patients in the NA group had greater postop leg strength (lbs) (24.7 vs. 18.5, t=3.76, p<0.001) and a smaller decrease in leg strength after surgery (-2.8 vs. -8.7, t=9.96, p<0.001). In contrast, results also showed that the leg strength of the non-operated leg was higher postop in both the NA group (0.6, p<0.001) and TA (0.8, p<0.001) arthroscopy group. Significantly less arthroscopic fluid was required for completion of the procedure in the NA group (479 ml) compared to patients in the TA group (2,568ml t=-38.51, p<0.001). Mean VAS score was significantly lower in the NA group (2.5) versus the TA (M=3.1, t=-3.25, p=0.002). The reduction in VAS pain scores was lower in the NA group (M=-1.8) versus the TA group (M=-1.1, t=-3.45, p=0.001).

Conclusion: The use of a small-bore needle arthroscope for visualization during arthroscopic partial meniscectomy is associated with improved retention of quadriceps function and less postoperative pain in the early postoperative period compared to a traditional arthroscope.