Clinical examination of the knee joint of 16 meniscectomy patients was performed and muscle biopsies were taken preoperatively and four weeks postoperatively from the vastus medialis of the quadriceps muscle. Corresponding investigations were performed in 15 healthy volunteer controls. One group of the meniscectomy patients was given routine postoperative physiotherapy, the other group intensive physiotherapy. Type I and II muscle fibres were determined from the muscle biopsies of the myosin-ATPase staining method. No difference was observed in the clinical and histochemical findings between the patients given routine and intensive physiotherapy respectively. Compared with the controls, the older patients had clinical quadriceps atrophy preoperatively, but there were no differences in the muscle fibre composition. After meniscectomy the patients developed even more marked quadriceps atrophy, which was more manifest in the patients with a good preoperative muscle status. The surface areas of the type I and II fibres of the operated patients diminished compared with the samples from the healthy volunteer controls. Only in the male patients was the decrease in the type I muscle area considerable. The present data indicate that meniscectomy is accompanied by a marked change in the clinical and histochemical appearance of the quadriceps muscle compared with the muscle status following meniscus injury; the extent of physiotherapy as carried out in the present study did not significantly modify the results.

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