Functional outcomes of patients with discoid meniscus undergoing surgery in a children’s orthopedic clinic
DOI:
https://doi.org/10.1016/j.rccot.2022.06.008Keywords:
discoid meniscus, arthroscopy, lateral meniscusAbstract
Introduction: The discoid meniscus is a meniscal malformation that can generate symptoms in children and adolescents. Arthroscopic techniques have been developed achieving improved functionality in the vast majority of patients with discoid meniscus and associated lesions. The objective is to show the clinical and functional results of patients operated by arthroscopy in a reference center in pediatric orthopedics during a period of 3 years.Materials and methods: The results of a retrospective cohort of patients under 18 years of age treated surgically for symptomatic discoid meniscus over a 3-year period were analyzed by reviewing medical records and evaluating clinical outcomes using the Tegner-Lysholm scale.
Results: Twenty-five knees were operated on in 21 patients with an average age of 8.9 years. The average follow-up time was 8.3 months, 60% of the knees had peripheral rim instability. Ninety-two percent of the patients had an excellent score (>90) on the Tegner-Lysholm scale and the remaining 8% had a good score. Eighty-eight percent of the cases had no postoperative pain and 12% had mild pain. Return to sport occurred within the first 4 months in 19 patients.
Conclusion: Arthroscopic treatment of symptomatic discoid meniscus with meniscal remodeling and stabilization of the peripheral rim has good functional results in the short and medium term, allowing patients to return to their activities in a short period of time.
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References
Kocher MS, Klingele K, Rassman SO. Meniscal disorders: nor- mal, discoid, and cysts. Orthop Clin North Am. 2003;34:329-40, https://doi.org/10.1016/S0030-5898(03)00008-7
Jordan MR. Lateral meniscal variants. Oper Tech Ort- hop. 2000;10:191-200, https://doi.org/10.1016/S1048-6666(00)80010-5
Kocher MS, Logan CA, Kramer DE. Discoid Lateral Menis- cus in Children: Diagnosis, Management, and Outcomes. J Am Acad Orthop Surg. 2017;25:736-43, https://doi.org/10.5435/JAAOS-D-15-00491
Watanabe M, Takeda S, Ikeuchi H. Atlas of Arthroscopy. 2nd ed. Tokyo, Japan;. 1969.
Klingele KE, Kocher MS, Hresko MT, Gerbino P, Micheli LJ. Discoid Lateral Meniscus: Prevalence of Peripheral Rim Ins- tability. J Pediatr Orthop. 2004:79-82, https://doi.org/10.1097/00004694-200401000-00015
Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985:43-9. https://doi.org/10.1097/00003086-198509000-00007
Randhawa S, Tran E, Segovia NA, et al. Epidemiological Study of the Discoid Meniscus: Investigating Demographic-Based Predic- tors in Large-Scale Claims Database. Cureus. 2021;13:e20050, https://doi.org/10.7759/cureus.20050
Hashimoto Y, Yamasaki S, Reid JB, 3rd, Guttmann D, Nis- hino K, Nakamura H. Arthroscopic Saucerization With Inside-Out Repair and Anterocentral Shift of a Discoid Lateral Meniscus With Retention of Adequate Volume of Residual Meniscus. Arthrosc Tech. 2021;10:e2553-7, https://doi.org/10.1016/j.eats.2021.07.039
Logan CA, Tepolt FA, Kocher SD, Feroe AG, Micheli LJ, Kocher MS. Symptomatic Discoid Meniscus in Children and Adolescents: A Review of 470 Cases. J Pediatr Orthop. 2021;41:496-501, https://doi.org/10.1097/BPO.0000000000001907
Vinagre G, Cruz F, Alkhelaifi K, D'Hooghe P. Isolated meniscus injuries in skeletally immature children and adolescents: state of the art. J ISAKOS. 2022;7:19-26, https://doi.org/10.1136/jisakos-2020-000496
Carabajal M, Allende GJ, Masquijo JJ. Resultados a mediano plazo de la remodelación artroscópica asociada a reparación periférica en niños con menisco discoide inestable. Rev Esp Cir Ortop Traumatol. 2020;64:206-12, https://doi.org/10.1016/j.recot.2019.10.002
Yang SJ, Ding ZJ, Li J, Xue Y, Chen G. Factors influencing postoperative outcomes in patients with symptomatic discoid lateral meniscus. BMC Musculoskelet Disord. 2020;21:551, https://doi.org/10.1186/s12891-020-03573-y