Meniscoplasty leads to good mid-term to long-term outcomes for children and adolescents with discoid lateral meniscus

Ng, Yau Hong; Tan, Si Heng Sharon; Lim, Andrew Kean Seng; Hui, James

doi:10.1007/s00167-020-05929-2

Cited by 29 publications

(54 citation statements)

References 22 publications

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“…Wong et al [28] concluded that there was no significant difference in the postoperative outcomes among these three surgical methods. Some studies have found no difference between meniscoplasty and total meniscectomy as to shortterm clinical outcomes [36][37][38], but the clinical efficacy of meniscoplasty is better than that of total meniscectomy in the long-term follow-up [3,24,[38][39][40][41][42]. Other studies have shown that the long-term outcomes of meniscoplasty with or without repair are satisfactory, without statistical difference [9,38,39,41,43,44].…”

Section: Discussionmentioning

confidence: 99%

Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

Yang

et al. 2021

Arch Orthop Trauma Surg

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Introduction The postoperative effect of arthroscopy in the treatment of symptomatic discoid lateral meniscus (DLM) varies greatly among individuals. Therefore, this study aims to investigate the factors affecting the postoperative outcomes of symptomatic DLM. Materials and methods According to the inclusion and exclusion criteria, patients with symptomatic single-knee DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were included. Retrospectively collected 16 factors probably affecting postoperative outcomes. The Ikeuchi grade system was used to evaluate the knee joint function. Univariate analysis was performed by Kruskal–Wallis rank-sum test or Mann–Whitney U test, and multivariate analysis by ordered logistic regression. P < 0.05 was considered statistically significant. Results A sum of 502 patients was included, including 353 females (70.3%) and 149 males (29.7%). Difference between preoperative and postoperative Ikeuchi grade was statistically significant (P < 0.001). Female was bad to obtain a good Ikeuchi grade (P = 0.009, OR 0.458). Outerbridge grade (P = 0.018, OR 0.638) was negatively correlated with Ikeuchi grade. BMI (P = 0.001, OR 0.875) and work intensity (P = 0.020, OR 0.611) were inversely correlated with Ikeuchi grade. Age of onset (P < 0.001, OR 0.956) and symptoms duration (P < 0.001, OR 0.988) were negatively correlated with Ikeuchi grade. Besides, compared to total meniscectomy, meniscoplasty with a repair was an unfavourable factor for Ikeuchi grade (P = 0.044, OR 0.245). Conclusions With the increase of BMI, work intensity, age of onset, duration of symptoms, and the severity of cartilage lesion, the postoperative results become worse. Moreover, female and meniscoplasty with repair are risk factors for the postoperative outcomes.

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Section: Discussionmentioning

confidence: 99%

Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

Yang

et al. 2021

Arch Orthop Trauma Surg

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“…As a general rule, preservation of as much meniscal tissue as possible is preferred for long-term joint health, thus repair should be considered as a first option. 2 , 6 , 8 , 9 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

“… 6 , 7 Standard treatment includes arthroscopic saucerization and repair/stabilization, as needed. 2 , 8 , 9 , 10 When intrasubstance degeneration (ID) is present, it is often not seen until near completion of saucerization because of its presence on the outer portion of the meniscus. The meniscus will typically split into a superior and inferior leaflet, and the decision has to be made to repair them or resect one or both based on intraoperative assessment of thickness and tissue quality.…”

Section: Introductionmentioning

confidence: 99%

Discoid Lateral Meniscus Saucerization and Treatment of Intrasubstance Degeneration Through an Accessory Medial Portal Using a Small Arthroscope

Pace

Łuczak

Kanski

et al. 2021

Arthroscopy Techniques

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Discoid lateral meniscus (DLM) is a rare meniscal variant characterized by an increased amount of meniscal tissue that resembles the shape of a disc as opposed to the typical crescent shape of the lateral meniscus. Surgical intervention is recommended for symptomatic DLM with persistent pain, mechanical symptoms, or motion impairment. The technique described is a reliable and reproducible method to identify and treat intrasubstance degeneration (ID) in the setting of DLM. A small arthroscope is used that allows more room for a meniscal repair device, as well as improved visualization and access of the lateral compartment. An accessory medial portal is used that allows perpendicular access to the anterior half of the body, as well as the posterior aspect of the anterior horn for repair. Successful surgery with this technique preserves meniscus and produces a strong reliable all-meniscal based repair of ID that allows early weight bearing and range of motion postoperatively.

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“…In the past, open surgery was the only solution to improve the shape and function of the meniscus. However, with the wide application of arthroscopy, treatment with minimal invasion has become the current mainstream treatment for discoid meniscus (9). Studies have shown that with arthroscopy, a clear diagnosis, small trauma, quick postoperative recovery, and low incidence of complications such as infection can be achieved (10).…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of arthroscopy in the treatment of discoid meniscus injury and related risk factors for postoperative pain

Lu¹,

Chen²,

Hu³

et al. 2020

Ann Palliat Med

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Background: Discoid meniscus is an abnormal meniscus of the knee joint. This study aimed to analyze the clinical efficacy of arthroscopy in the treatment of discoid meniscus injury, and determine the related risk factors for postoperative pain.Methods: A total of 80 patients with a discoid meniscus injury who were diagnosed and treated in our hospital from May 2017 to May 2018 were selected. According to the different surgical methods, they were divided into the study group (treated with meniscus plasty) or the control group (treated with subtotal meniscectomy). Knee joint motion and knee joint function were measured at 2, 6 and 12 weeks post-surgery.Knee joint function was measured using the Lysholm Knee Scoring Scale to determine clinical efficacy.Patients with an excellent and good rating were included in the painless group, and patients with an average and poor rating were included in the pain group. The risk factors for postoperative pain were analyzed using multivariate logistic regression.Results: Knee joint motion in the study group and the control group gradually increased and reached a peak 12 weeks after surgery (P<0.05), however, there was no significant difference between the 2 groups at each time point after surgery (P>0.05). The excellent and good rate, according to the Lysholm Knee Scoring Scale, was 84.62% in the study group and 84.38% in the control group. There was no significant difference between the 2 groups (P>0.05). There were differences between the pain group and the painless group in Watanabe classification, age, preoperative symptom time, cold compress, joint soft tissue injury, and postoperative weight-bearing time ≤1 week (P<0.05).Conclusions: Arthroscopy demonstrated efficacy for the treatment of patients with a discoid meniscus injury. Age, duration of preoperative symptoms, articular cartilage injury, postoperative cold compress and postoperative weight-bearing time were independent risk factors that affected postoperative pain after arthroscopic surgery. For high-risk patients, effective prevention and control measures should be taken to improve postoperative pain and promote the recovery of knee joint function.

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Meniscoplasty leads to good mid-term to long-term outcomes for children and adolescents with discoid lateral meniscus

Cited by 29 publications

References 22 publications

Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

Discoid Lateral Meniscus Saucerization and Treatment of Intrasubstance Degeneration Through an Accessory Medial Portal Using a Small Arthroscope

Clinical efficacy of arthroscopy in the treatment of discoid meniscus injury and related risk factors for postoperative pain

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