Jin Hwan Ahn1, Kang-Il Kim2, Joon Ho Wang3, Jong Wook Jeon2, Young Chu Cho2, Sang Hak Lee4. 1. Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea. 2. Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea. 3. Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea. 4. Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea. Electronic address: sangdory@hanmail.net.
Abstract
PURPOSE: To assess the long-term clinical and radiographic results of arthroscopic reshaping with or without peripheral meniscus repair for the treatment of symptomatic discoid lateral meniscus in children. METHODS: This study included 38 children (48 knees) who underwent arthroscopic surgery for symptomatic discoid lateral meniscus. The mean age at operation was 9.9 years (range, 4 to 15 years), and the mean follow-up period was 10.1 years (range, 8 to 14 years). Arthroscopic partial meniscectomy was performed in 22 knees (group A); partial meniscectomy with repair, in 18 knees (group B); and subtotal meniscectomy, in 8 knees (group C). Clinical and radiographic results were evaluated preoperatively and at the final follow-up. RESULTS: According to the scale of Ikeuchi, 94% of cases showed excellent or good results clinically. At the final follow-up, the median Tegner activity level was 7 (range, 4 to 10). The mean Lysholm knee score improved from 74.9 ± 10.6 to 97.6 ± 4.0, and the mean Hospital for Special Surgery score improved from 80.8 ± 8.9 to 97.8 ± 3.6 (P < .0001). At the final follow-up, radiographic evaluation showed the development of minor osteophytes in the lateral compartment of 18 knees and moderate joint space narrowing with spur formation in 1 knee. In addition, degenerative changes were observed in 23% of cases in group A, 39% of cases in group B, and 88% of cases in group C. Group C showed significantly greater progression of degenerative changes than group A or B. CONCLUSIONS: Arthroscopic reshaping for symptomatic discoid lateral meniscus in children led to satisfactory clinical outcomes after a mean of 10.1 years. However, progressive degenerative changes appeared in 40% of the patients. The subtotal meniscectomy group had significantly increased degenerative changes compared with partial meniscectomy with or without repair. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
PURPOSE: To assess the long-term clinical and radiographic results of arthroscopic reshaping with or without peripheral meniscus repair for the treatment of symptomatic discoid lateral meniscus in children. METHODS: This study included 38 children (48 knees) who underwent arthroscopic surgery for symptomatic discoid lateral meniscus. The mean age at operation was 9.9 years (range, 4 to 15 years), and the mean follow-up period was 10.1 years (range, 8 to 14 years). Arthroscopic partial meniscectomy was performed in 22 knees (group A); partial meniscectomy with repair, in 18 knees (group B); and subtotal meniscectomy, in 8 knees (group C). Clinical and radiographic results were evaluated preoperatively and at the final follow-up. RESULTS: According to the scale of Ikeuchi, 94% of cases showed excellent or good results clinically. At the final follow-up, the median Tegner activity level was 7 (range, 4 to 10). The mean Lysholm knee score improved from 74.9 ± 10.6 to 97.6 ± 4.0, and the mean Hospital for Special Surgery score improved from 80.8 ± 8.9 to 97.8 ± 3.6 (P < .0001). At the final follow-up, radiographic evaluation showed the development of minor osteophytes in the lateral compartment of 18 knees and moderate joint space narrowing with spur formation in 1 knee. In addition, degenerative changes were observed in 23% of cases in group A, 39% of cases in group B, and 88% of cases in group C. Group C showed significantly greater progression of degenerative changes than group A or B. CONCLUSIONS: Arthroscopic reshaping for symptomatic discoid lateral meniscus in children led to satisfactory clinical outcomes after a mean of 10.1 years. However, progressive degenerative changes appeared in 40% of the patients. The subtotal meniscectomy group had significantly increased degenerative changes compared with partial meniscectomy with or without repair. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors: Jonathan D Haskel; Tyler J Uppstrom; David M Dare; Scott A Rodeo; Daniel W Green Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-01-05 Impact factor: 4.342
Authors: Benjamin Johnson; Catriona Heaver; Robin Gilbert; Andrew Roberts Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-04-27 Impact factor: 4.342