Discoid lateral meniscus instability in children: part II.: Repair first to minimise the saucerisation.
Arthroscopy
Children
Clinical pattern
Discoid lateral meniscus
Failure
Instability
Knee
MRI
Paediatric
Repair
Results
Suture
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
06
06
2020
accepted:
01
08
2023
pubmed:
4
9
2023
medline:
4
9
2023
entrez:
2
9
2023
Statut:
ppublish
Résumé
Despite an improved understanding of discoid lateral meniscus (DLM), the treatment of symptomatic discoid lateral meniscus remains controversial. The aim of this retrospective, single-centred, consecutive-case study was to evaluate the clinical outcome of 60 DLM treated arthroscopically by the "meniscoplasty or saucerisation-suture" technique in children and adolescents [median (range) age 11 (4-17) years], and to investigate surgical failures. The instability was assessed before any saucerisation. The hypotheses were that: (i) the management of instability with suture first was effective and that (ii) a combined classification with clinical and MRI data had a prognostic value. In 57 knees (95%), the DLM was unstable, and a suture fixation was performed. After a median follow-up of 41.5 months, the median (range) IKDC score was improved from 55 (10-70) preoperatively to 90 (37.5-100) postoperatively. The median (range) Lysholm score at last follow-up was 93.5 (45-100). The procedure was effective in 49 knees (81.6%) after a single procedure. Eleven patients had a failure with a new meniscal tear after a median (range) delay of 42 months (24-60) after the initial procedure. The patterns of discoid lateral meniscus instability were not found to have a prognostic value for surgical failure since they mainly occurred after sport-related injuries. All the patients with initial repair failures but one achieved a good clinical outcome after revision repair without any further meniscectomy. In contrast to adult knees, symptomatic discoid lateral meniscus is rarely stable in children (5%). Meniscal repair is effective to preserve the meniscus tissue, but revision repair became necessary in 18% of the cases and was finally successful. Level of evidence Level III.
Identifiants
pubmed: 37659011
doi: 10.1007/s00167-023-07538-1
pii: 10.1007/s00167-023-07538-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4816-4823Informations de copyright
© 2023. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
Références
Adachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R (2004) Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear. Arthroscopy 20(5):536–542
doi: 10.1016/j.arthro.2004.01.028
pubmed: 15122147
Ahn JH, Kim KI, Wang JH, Jeon JW, Cho YC, Lee SH (2015) Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthroscopy 31(5):867–873
doi: 10.1016/j.arthro.2014.12.012
pubmed: 25665957
Ahn JH, Lee YS, Ha HC, Shim JS, Lim KS (2009) A novel magnetic resonance imaging classification of discoid lateral meniscus based on peripheral attachment. Am J Sports Med 37(8):1564–1569
doi: 10.1177/0363546509332502
pubmed: 19439757
Ahn JH, Lee SH, Kim KI, Nam J (2018) Arthroscopic meniscus repair for recurrent subluxation of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 26(3):787–792
doi: 10.1007/s00167-017-4420-2
pubmed: 28258328
Ahn JH, Lee SH, Yoo JC, Lee YS, Ha HC (2008) Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up. Arthroscopy 24(8):888–898
doi: 10.1016/j.arthro.2008.03.002
pubmed: 18657737
Asik M, Sen C, Taser OF, Alturfan AK, Sozen YV (2003) Discoid lateral meniscus: diagnosis and results of arthroscopic treatment. Knee Surg Sports Traumatol Arthrosc 11(2):99–104
doi: 10.1007/s00167-002-0341-8
pubmed: 12664202
Beck JJ, Schlechter J, Schmale G, Haus B, Lee J (2022) Comprehensive arthroscopic characterization of discoid meniscus tears and instability using the PRiSM discoid meniscus classification. Arthrosc Tech 11(7):e1347–e1352
doi: 10.1016/j.eats.2022.03.018
pubmed: 35936837
pmcid: 9353536
Bin SI, Jeong SI, Kim JM, Shon HC (2002) Arthroscopic partial meniscectomy for horizontal tear of discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 10(1):20–24
doi: 10.1007/s001670100241
pubmed: 11819016
Carter CW, Hoellwarth J, Weiss JM (2012) Clinical outcomes as a function of meniscal stability in the discoid meniscus: a preliminary report. J Pediatr Orthop 32(1):9–14
doi: 10.1097/BPO.0b013e31823d8338
pubmed: 22173381
Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM (2011) Measures of knee function: international knee documentation committee (IKDC) subjective knee evaluation form, knee injury and osteoarthritis outcome score (KOOS), knee injury and osteoarthritis outcome score physical function short form (KOOS-PS), knee outcome survey activities of daily living scale (KOS-ADL), Lysholm knee scoring scale, Oxford knee score (OKS), western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), activity rating scale (ARS), and Tegner activity score (TAS). Arthritis Care Res 63(Suppl 11):S208-228
Dai Z, Chen J, Chen S, Chen Z, Fan W, Liao Y, Jiang J (2011) Meniscal plasty and suture repair for torn discoid lateral meniscus involving popliteal hiatus. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 25(1):13–16
pubmed: 21351601
Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA (2007) Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. Arthroscopy 23(2):157–163
doi: 10.1016/j.arthro.2006.09.002
pubmed: 17276223
Hagino T, Ochiai S, Senga S, Yamashita T, Wako M, Ando T, Haro H (2017) Arthroscopic treatment of symptomatic discoid meniscus in children. Arch Orthop Trauma Surg 137(1):89–94
doi: 10.1007/s00402-016-2575-9
pubmed: 27695981
Hashimoto Y, Yamasaki S, Guttmann D, Reid JB 3rd, Marvil S, Kinoshita T, Nakamura H (2022) Surgical management of discoid lateral meniscus with anterior peripheral instability: retaining an adequate residual meniscus volume. Arthrosc Tech 11(7):e1141–e1147
doi: 10.1016/j.eats.2022.02.021
pubmed: 35936849
pmcid: 9353039
Haskel JD, Uppstrom TJ, Dare DM, Rodeo SA, Green DW (2018) Decline in clinical scores at long-term follow-up of arthroscopically treated discoid lateral meniscus in children. Knee Surg Sports Traumatol Arthrosc 26(10):2906–2911
doi: 10.1007/s00167-017-4825-y
pubmed: 29305617
Kang MS, Kim JM, Park SS, Bin SI (2019) Prediction of the peripheral rim instability of the discoid lateral meniscus in children by using preoperative clinicoradiological factors. J Pediatr Orthop 39(10):e761–e768
doi: 10.1097/BPO.0000000000001370
pubmed: 30950939
Kinugasa K, Hamada M, Yonetani Y, Matsuo T, Mae T, Nakata K, Horibe S (2019) Discoid lateral meniscal repair without saucerization for adolescents with peripheral longitudinal tear. Knee 26(3):803–808
doi: 10.1016/j.knee.2019.03.007
pubmed: 31076246
Kim SH, Ahn J, Kim TW, Kim KI, Lee SH (2019) Midbody of the medial meniscus as a reference of preservation in partial meniscectomy for complete discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 27(8):2558–2567
doi: 10.1007/s00167-018-5268-9
pubmed: 30406407
Klingele KE, Kocher MS, Hresko MT, Gerbino P, Micheli LJ (2004) Discoid lateral meniscus: prevalence of peripheral rim instability. J Pediatr Orthop 24(1):79–82
doi: 10.1097/01241398-200401000-00015
pubmed: 14676539
Kocher MS, Logan CA, Kramer DE (2017) Discoid Lateral meniscus in children: diagnosis, management, and outcomes. J Am Acad Orthop Surg 25(11):736–743
doi: 10.5435/JAAOS-D-15-00491
pubmed: 29059110
Lee DH, D’Lima DD, Lee SH (2019) Clinical and radiographic results of partial versus total meniscectomy in patients with symptomatic discoid lateral meniscus: a systematic review and meta-analysis. Orthop Traumatol Surg Res 105(4):669–675
doi: 10.1016/j.otsr.2019.02.023
pubmed: 31027980
Lee RJ, Nepple JJ, Schmale GA, Niu EL, Beck JJ, Milewski MD, Finlayson CJ, Joughin VE, Stinson ZS, Pace JL, PRiSM Meniscus Research Interest Group, Albright J, Carsen S, Chambers H, Nault ML, Schlechter JA, Stavinoha TJ, Tompkins M, Wilson PL, Heyworth BE (2022) Reliability of a new arthroscopic discoid lateral meniscus classification system: a multicenter video analysis. Am J Sports Med 50(5):1245–1253
doi: 10.1177/03635465221076857
pubmed: 35234542
Lins LAB, Feroe AG, Yang B, Williams KA, Kocher SD, Sankarankutty S, Micheli LJ, Kocher MS (2021) Long-term minimum 15-year follow-up after lateral discoid meniscus rim preservation surgery in children and adolescents. J Pediatr Orthop 41(9):e810–e815
doi: 10.1097/BPO.0000000000001903
pubmed: 34411050
Liu W, Fu C, Kang K, Huang T, Jiang S, Gu J, Gao S (2022) Evaluation of tibial eminence morphology using magnetic resonance imaging (MRI) in juvenile patients with complete discoid lateral meniscus. BMC Musculoskelet Disord 23(1):1022
doi: 10.1186/s12891-022-06002-4
pubmed: 36443796
pmcid: 9706916
Logan CA, Tepolt FA, Kocher SD, Feroe AG, Micheli LJ, Kocher MS (2021) Symptomatic discoid meniscus in children and adolescents: a review of 470 cases. J Pediatr Orthop 41(8):496–501
doi: 10.1097/BPO.0000000000001907
pubmed: 34397782
Ng YH, Tan SHS, Lim AKS, Hui JH (2021) Meniscoplasty leads to good mid-term to long-term outcomes for children and adolescents with discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 29(2):352–357
doi: 10.1007/s00167-020-05929-2
pubmed: 32166389
Ohnishi Y, Nakashima H, Suzuki H, Nakamura E, Sakai A, Uchida S (2018) Arthroscopic treatment for symptomatic lateral discoid meniscus: the effects of different ages, groups and procedures on surgical outcomes. Knee 25(6):1083–1090
doi: 10.1016/j.knee.2018.06.003
pubmed: 30115588
Papadopoulos A, Kirkos JM, Kapetanos GA (2009) Histomorphologic study of discoid meniscus. Arthroscopy 25(3):262–268
doi: 10.1016/j.arthro.2008.10.006
pubmed: 19245988
Perkins CA, Busch MT, Christino MA, Willimon SC (2021) Saucerization and repair of discoid lateral menisci with peripheral rim instability: intermediate-term outcomes in children and adolescents. J Pediatr Orthop 41(1):23–27
doi: 10.1097/BPO.0000000000001695
pubmed: 33044260
Smuin DM, Swenson RD, Dhawan A (2017) Saucerization versus complete resection of a symptomatic discoid lateral meniscus at short- and long-term follow-up: a systematic review. Arthroscopy 33(9):1733–1742
doi: 10.1016/j.arthro.2017.03.028
pubmed: 28865577
Vandergugten S, Bauwens PH, Fiquet C, Boyer H, Raux S, Cance N, Chotel F (2023) Discoid lateral meniscus instability in children: part I. A new grading system of instability to clarify natural history. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-023-07521-w
doi: 10.1007/s00167-023-07521-w
Wasser L, Knörr J, Accadbled F, Abid A, Sales De Gauzy J (2011) Arthroscopic treatment of discoid meniscus in children: clinical and MRI results. Orthop Traumatol Surg Res 97(3):297–303
doi: 10.1016/j.otsr.2010.11.009
pubmed: 21435965
Yamaguchi N, Chosa E, Tajima T, Morita Y, Yokoe T (2022) Symptomatic discoid lateral meniscus shows a relationship between types and tear patterns, and between causes of clinical symptom onset and the age distribution. Knee Surg Sports Traumatol Arthrosc 30(4):1436–1442
doi: 10.1007/s00167-021-06635-3
pubmed: 34110457
Yamasaki S, Hashimoto Y, Takigami J, Terai S, Takahashi S, Nakamura H (2017) Risk factors associated with knee joint degeneration after arthroscopic reshaping for juvenile discoid lateral meniscus. Am J Sports Med 45(3):570–577
doi: 10.1177/0363546516668623
pubmed: 28272930
Yilgor C, Atay OA, Ergen B, Doral MN (2014) Comparison of magnetic resonance imaging findings with arthroscopic findings in discoid meniscus. Knee Surg Sports Traumatol Arthrosc 22(2):268–273
doi: 10.1007/s00167-013-2371-9
pubmed: 23338662
Yoo WJ, Choi IH, Chung CY, Lee MC, Cho TJ, Park MS, Lee DY (2008) Discoid lateral meniscus in children: limited knee extension and meniscal instability in the posterior segment. J Pediatr Orthop 28(5):544–548
doi: 10.1097/BPO.0b013e31817766dd
pubmed: 18580370