Arthroscopic partial meniscectomy in young patients with symptomatic discoid lateral meniscus: an average 10-year follow-up study

Lee, Chang-Rack; Bin, Seong‐Il; Kim, Jong Min; Lee, Bum-Sik; Kim, Nam-Ki

doi:10.1007/s00402-017-2853-1

Cited by 39 publications

(65 citation statements)

References 28 publications

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“…For symptomatic DLM, numerous studies have found that the earlier the age of onset is, the shorter is the duration of symptoms (especially <12 months) and that the earlier the surgical intervention is performed, the better is the prognosis [5,11,31,38,49]. We found that the age of onset <25 years, especially <14 years (P < 0.001, OR = 37.069; 95% CI: 7.822-55.147), and the symptoms duration <24 months (P < 0.001, OR = 3.254; 95% CI: 1.855-5.703) are advantageous for postoperative e cacy.…”

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

“…We found that the age of onset <25 years, especially <14 years (P < 0.001, OR = 37.069; 95% CI: 7.822-55.147), and the symptoms duration <24 months (P < 0.001, OR = 3.254; 95% CI: 1.855-5.703) are advantageous for postoperative e cacy. It has been reported that the younger age of onset and a shorter course of the disease are correlated with a lower risk of articular chondromalacia and damage caused by DLM lesions [2,17,31]. Moreover, early normalization of DLM morphology by surgery not only increases the mobility of the meniscus, but also enhances the adaptability of the meniscus to the tibiofemoral surface, thereby reducing damage and degeneration of the meniscus and articular cartilage arising from excessive stress concentration [15,31,38].…”

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

“…Ahn et al [4] considered that partial meniscectomy with repair has a good e cacy in children with symptomatic DLM compared with total meniscectomy; this may be because partial meniscectomy with repair can prevent early degenerative changes of the joint [36]. However, Lee et al [31] harbour the opposite opinion that residual discoid meniscus tissue is prone to degeneration and re-injury due to its abnormally brous structure, which may lead to adverse clinical effects. Considering the high cost and uncertain effectiveness of repair, repair of the abnormal anatomy in a torn DLM is not recommended [44].…”

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

“…Patients suffering from bilateral DLM accounts for 79%-97% of cases [33]. Symptomatic DLM, characterized by pain, swelling, snapping, locking, knee instability and limited mobility [12,27], is mainly diagnosed by magnetic resonance imaging (MRI) and treated by arthroscopic surgery [31]. Although the overall postoperative clinical outcomes of symptomatic DLM are acceptable [11,17,38], the outcomes still differ among individuals, possibly as a result of the diversity in patient characteristics and treatments [31].…”

Section: Introductionmentioning

confidence: 99%

“…Symptomatic DLM, characterized by pain, swelling, snapping, locking, knee instability and limited mobility [12,27], is mainly diagnosed by magnetic resonance imaging (MRI) and treated by arthroscopic surgery [31]. Although the overall postoperative clinical outcomes of symptomatic DLM are acceptable [11,17,38], the outcomes still differ among individuals, possibly as a result of the diversity in patient characteristics and treatments [31]. Recently studies have reported several factors that in uence postoperative effect in symptomatic DLM, but the sample sizes used in these studies are uneven, and the results are inconsistent [10][11]19,28].…”

Section: Introductionmentioning

confidence: 99%

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Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Yang

Ding

et al. 2020

Preprint

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Background: Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; however, postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM. Methods: Patients with DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were enrolled according to the inclusion and exclusion criteria. Fourteen variables, including sex, body mass index (BMI) and other variables, were chosen as factors for study. Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Univariate analyses (Mann-Whitney U test or Kruskall-Wallis rank sum test) and multivariate analyses (ordinal logistic regression) were used to identify the factors that influenced postoperative outcomes. P<0.05 was considered statistically significant.Results: A total of 502 patients, including 353 females (70.3%) and 149 males (29.7%), were enrolled. The median IKDC score postoperatively (87.4; range, 41.4~97.7; IQR, 14.6) was higher than that preoperatively (57.6; range, 26.9~ 64.9; IQR, 9.7) (P<0.001). Male sex was predictive of a higher IKDC score (P=0.023, OR=1.702). Compared with BMI ≥25 kg/m2, <18.5 kg/m2 was associated with better IKDC score (P=0.026, OR=3.016). Contrasting with age of onset ≥45 years, ≤14 years (P<0.001, OR=20.780) and 14~25 years (P<0.001, OR=8.516) were associated with better IKDC score. In comparison with symptoms duration>24 months, IKDC scores for patients with symptoms duration ≤1 month (P=0.001, OR=3.511), 1 ~ 6 months (P < 0.001, OR = 3.463) and 6 ~ 24 months (P < 0.001, OR = 3.254) were significantly elevated. Compared to Outerbridge grade III ~ IV, no injury (P<0.001, OR=6.379) and grade I (P=0.01, OR=4.332) were associated with higher IKDC score.Conclusions: Arthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5kg/m2, age of onset < 25 years (especially < 14 years) and symptoms duration < 24 months are conducive to good postoperative outcomes. However, combined articular cartilage injury (Outbridge grade≥2) reduces postoperative effect.

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Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Yang

Ding

et al. 2020

Preprint

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Age and medial compartmental OA were important predictors of the lateral compartmental OA in the discoid lateral meniscus: Analysis using machine learning approach

Cho,

Kim,

Nam

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe objective of this study was to develop a machine learning model that would predict lateral compartment osteoarthritis (OA) in the discoid lateral meniscus (DLM), from which to then identify factors contributing to lateral compartment OA, with a key focus on the patient's age.MethodsData were collected from 611 patients with symptomatic DLM diagnosed using magnetic resonance imaging between April 2003 and May 2022. Twenty features, including demographic, clinical and radiological data and six algorithms were used to develop the predictive machine learning models. Shapley additive explanation (SHAP) analysis was performed on the best model, in addition to subgroup analyses according to age.ResultsExtreme gradient boosting classifier was identified as the best prediction model, with an area under the receiver operating characteristic curve (AUROC) of 0.968, the highest among all the models, regardless of age (AUROC of 0.977 in young age and AUROC of 0.937 in old age). In the SHAP analysis, the most predictive feature was age, followed by the presence of medial compartment OA. In the subgroup analysis, the most predictive feature was age in young age, whereas the most predictive feature was the presence of medial compartment OA in old age.ConclusionThe machine learning model developed in this study showed a high predictive performance with regard to predicting lateral compartment OA of the DLM. Age was identified as the most important factor, followed by medial compartment OA. In subgroup analysis, medial compartmental OA was found to be the most important factor in the older age group, whereas age remained the most important factor in the younger age group. These findings provide insights that may prove useful for the establishment of strategies for the treatment of patients with symptomatic DLM.Level of EvidenceLevel III.

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Assessment of Knee Cartilage Injury: Arthroscopic Evaluation and Classification

Dwyer

Theodoropoulos

2020

Articular Cartilage of the Knee

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Arthroscopic partial meniscectomy in young patients with symptomatic discoid lateral meniscus: an average 10-year follow-up study

Cited by 39 publications

References 28 publications

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Age and medial compartmental OA were important predictors of the lateral compartmental OA in the discoid lateral meniscus: Analysis using machine learning approach

Assessment of Knee Cartilage Injury: Arthroscopic Evaluation and Classification

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