Publication Date
11-1-2023
Journal
The American Journal of Sports Medicine
DOI
10.1177/03635465231206173
PMID
37899536
PMCID
PMC10623608
PubMedCentral® Posted Date
10-29-2023
PubMedCentral® Full Text Version
Post-print
Published Open-Access
no
Keywords
Humans, Child, Adolescent, Menisci, Tibial, Cohort Studies, Arthroscopy, Tibial Meniscus Injuries, Joint Diseases, Cartilage Diseases, Retrospective Studies
Abstract
BACKGROUND: Surgical treatment options of discoid lateral meniscus in pediatric patients consist of saucerization with or without meniscal repair, meniscocapular stabilization, and, less often, subtotal meniscectomy.
PURPOSE: To describe a large, prospectively collected multicenter cohort of discoid menisci undergoing surgical intervention, and further investigate corresponding treatment of discoid menisci.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: A multicenter quality improvement registry (16 institutions, 26 surgeons), Sports Cohort Outcomes Registry, was queried. Patient characteristics, discoid type, presence and type of intrasubstance meniscal tear, peripheral rim instability, repair technique, and partial meniscectomy/debridement beyond saucerization were reviewed. Discoid meniscus characteristics were compared between age groups (14 years old), based on receiver operating characteristic curve, and discoid morphology (complete and incomplete).
RESULTS: In total, 274 patients were identified (mean age, 12.4 years; range, 3-18 years), of whom 55.6% had complete discoid. Meniscal repairs were performed in 55.1% of patients. Overall, 48.5% of patients had rim instability and 36.8% had >1 location of peripheral rim instability. Of the patients, 21.5% underwent meniscal debridement beyond saucerization, with 8.4% undergoing a subtotal meniscectomy. Patients(
CONCLUSION: To preserve physiological "normal" meniscus, a repair may be indicated in >50% of patients14 years. Additional resection beyond the physiological rim may be needed in 15% of younger patients and 30% of those aged >14 years.