Purpose: Lateral meniscectomy is thought to confer a less optimal prognosis compared to medial meniscectomy however little information exists on the effect on elite sportsmen in the context of career performance and sporting ability.

Study type: Retrospective case study.

Methods: 61 international or premiership level sportsmen (36 Football, 22 Rugby, 3 Cricket) who had no previous significant knee surgery, received either medial or lateral partial meniscectomy by a single surgeon. Their subsequent career performance was analysed over a 1 to 5 year follow-up period to highlight differences in their recovery and maintenance of an elite sporting career.

Results: From our cohort 96% of sportsmen from the medial meniscectomy group were able to return to professional sports, compared to 88% in the lateral meniscectomy group. The average time to return to sports was 3.5 weeks in the medial meniscectomy group compared to 8 weeks in the lateral meniscectomy group. A statistically significant decrease in performance was noted in the lateral group, whereby 14 of the 36 sportsmen subsequently played in lower level leagues, or suffered premature retirement compared to only 1 sportsmen out of the 25 sportsmen who received a medial meniscectomy.

Conclusions: The majority of elite sportsmen who undergo partial meniscectomy are able to return to high level sporting activities and maintain their career. Unfortunately, sportsmen who undergo Lateral meniscectomy are at higher risk of not returning to their previous performance. If they do return to sport they are more likely to have diminished performance compared to those who have a medial meniscectomy. Lateral meniscectomy is associated with a relatively unpredictable recovery time-frame and higher risk of premature retirement. Athletes should be warned of these findings when treatment decisions are made.