Systematic Review of the Long-term Surgical Outcomes of Discoid Lateral Meniscus

Lee, Yong Seuk; Teo, Seow Hui; Ahn, Jin Hwan; Lee, O-Sung; Lee, Jun Young; Lee, Je Ho

doi:10.1016/j.arthro.2017.04.006

Cited by 55 publications

(60 citation statements)

References 26 publications

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“…Certainly some patients have symptoms of clunking and even locking at a very young age, but some have pain which requires surgery. [23][24][25][26] It is equally certain that many patients go through their entire lives with a discoid meniscus without any problems.…”

Section: Associated Problemsmentioning

confidence: 99%

The Natural History of Meniscus Tears

Chambers

2019

Journal of Pediatric Orthopaedics

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Background: In order to determine whether treatments are effective in the treatment of meniscus tears, it is first necessary to understand the natural history of meniscus tears. The purpose of this paper is to review the literature to ascertain the natural history of meniscus tears in children and adolescents. Methods: A search of the Pubmed and Embase databases was performed using the search terms "meniscus tears," "natural history of meniscus tears," "knee meniscus," "discoid meniscus," and "natural history of discoid meniscus tears." Results: A total of 2567 articles on meniscus tears, 28 articles on natural history of meniscus tears, 8065 articles on "menisci," 396 articles on "discoid meniscus," and only 2 on the "natural history of discoid meniscus" were found. After reviewing the titles of these articles and reviewing the abstracts of 237 articles, it was clear that there was little true long-term natural history data of untreated meniscus tears nor whether treating meniscus tears altered the natural history. Twenty-five articles were chosen as there was some mention of natural history in their studies. Conclusions: There are few long-term data on untreated meniscal tears or discoid meniscus, or tears in children and adolescents. The literature suggests that there is a higher incidence of chondral injury and subsequent osteoarthritis, but there are many confounding variables which are not controlled for in these relatively short-term papers.

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Section: Associated Problemsmentioning

confidence: 99%

The Natural History of Meniscus Tears

Chambers

2019

Journal of Pediatric Orthopaedics

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“…Longer follow-up is believed to be associated with more severe articular cartilage degeneration and clinical symptoms and worse knee joint function [31,34]. In our study, the median follow-up time was 75.4 (range, 41~123; IQR, 33.7) months, and the nal follow-up time was not correlated with postoperative e cacy of symptomatic DLM; this may be due to the small number of patients with followup time over 120 months.…”

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 54%

“…Considering the high cost and uncertain effectiveness of repair, repair of the abnormal anatomy in a torn DLM is not recommended [44]. Some scholars have not found the differences in clinical outcomes between partial meniscectomy and total meniscectomy in the short or medium term, but the clinical e cacy of partial meniscectomy is better than that of total meniscectomy in the long-term follow-up [2,3,9,25,34,44,47,50]. Conversely, Ikeuchi et al [23] reported that the results of partial meniscectomy were signi cantly worse than those of total meniscectomy.…”

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

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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“…Considering the high cost and uncertain effective of repair, repair of the abnormal anatomy in a torn DLM is not recommended [44]. Some scholars haven't found the difference of clinical outcomes between partial meniscectomy and total meniscectomy in the short-or medium-term, but the clinical efficacy of partial meniscectomy is better than that of total meniscectomy in the long-term follow-up [2,3,9,25,34,44,47,50]. Conversely, Ikeuchi et al [23] reported that the results of partial meniscectomy were significantly worse than those of total meniscectomy.…”

Section: Discussionmentioning

confidence: 99%

“…A longer follow-up is believed to be associated with more severe articular cartilage degeneration and clinical symptoms and worse knee joint function [31,34]. In our study, the median follow-up time was 75.4 (range, 41~123; IQR, 33.7) months, and the final follow-up time was not an influencing factor for the postoperative efficacy of symptomatic DLM, which may be due to the small number of patients with follow-up time over 120 months.…”

Section: Discussionmentioning

confidence: 99%

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Yang

Ding

et al. 2020

Preprint

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Background: Discoid lateral meniscus (DLM) have a higher rate of tear and degeneration for its abnormal shape and structure. Arthroscopy is the main treatment for symptomatic DLM, however, postoperative clinical outcomes vary widely resulting from effects of diverse factors. Therefore, the present research aims to explore the factors influencing postoperative clinical outcomes of symptomatic DLM . Methods: Patients with discoid meniscus who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were selected according to the inclusion and exclusion criteria. Gender, body mass index (BMI) ,and 18 other factors were selected as potential predictors that might affect postoperative outcomes . Knee function was assessed by the Lysholm, Tegner, International Knee Documentation Committee (IKDC) and Ikeuchi scales. Univariate analyses (rank-sum test and chi-squared test) and multivariate analyses (ordered logistic regression and logistic regression) were used to detect the risk factors bearing on postoperative outcomes. P<0.05 was considered statistically significant. Results: A total of 502 patients were enrolled. Female gender was an influencing factor for Lysholm (P=0.002, odds ratio (OR) =2.713), Tegner (P=0.001, OR=2.526) , IKDC (P=0.022, OR=1.735) and Ikeuchi scores (P=0.010, OR=2.164). BMI was negatively correlated with Lysholm (P=0.007, OR=1.119) and IKDC (P=0.029, OR=1.088) scores. Work intensity was negatively related to IKDC (P=0.038, OR=1.492) and Ikeuchi (P=0.014, OR=1.689) scores. Age of onset was inversely correlated with Tegner (P<0.001, OR=1.109) score.Symptoms duration and IKDC (P=0.002, OR=1.020) had an inverse correlation. Lack of cartilage lesions was a protective factor in terms of Tegner score (P<0.001, OR=0.261). Outerbridge grade was negatively correlated with Lysholm (P=0.016, OR=1.589) and Ikeuchi (P=0.017, OR=1.582) scores. Saucerization with repair was a risk factor for poor Ikeuchi scores (P=0.037, OR=4.328) in terms of subtotal/total meniscectomy. Conclusion: Arthroscopic treatment of symptomatic DLM is safe and effective . Female sex, cartilage lesions and saucerization with repair may be related to unfavourable postoperative outcomes. Clinical efficacy may worsen with increasingBMI, work intensity, symptomatic duration, age of onset and Outerbridge grade.

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Systematic Review of the Long-term Surgical Outcomes of Discoid Lateral Meniscus

Cited by 55 publications

References 26 publications

The Natural History of Meniscus Tears

The Natural History of Meniscus Tears

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

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