Arthroscopic treatment for symptomatic lateral discoid meniscus: The effects of different ages, groups and procedures on surgical outcomes

Abstract

Background: There is a paucity of literature regarding the results of arthroscopic saucerization, with or without stabilization, for lateral discoid meniscus (LDM) in children, and differences in clinical outcomes between adults and children. The purpose of this study was to compare the clinical outcomes following arthroscopic treatment of symptomatic LDM in children versus adults. Secondly, outcomes of different surgical procedures (saucerization only and saucerization with repair or centralization) were also compared.

Methods: Fifty-two consecutive patients with LDM were evaluated and divided into two groups. Group 1 had 16 patients (18 knees; nine males, seven females) aged <13 years; Group 2 had 36 patients (38 knees; 19 males, 17 females) aged ≥13 years. All patients were arthroscopically treated with saucerization only, or saucerization with repair or centralization for LDM. They had a mean follow-up of 30 months (range 24-72). Clinical outcomes were compared preoperatively and at final follow-up (minimum two years) after surgery using patient-reported outcome scores, International Knee Documentation Committee (IKDC) scores, and Lysholm scores. Radiographic evaluation was also performed for degenerative changes using Kellgren-Lawrence classification.

Results: The IKDC scores at final follow-up in Group 1 demonstrated better clinical outcomes when compared with those in Group 2 (91.1 ± 9.49 vs. 73.7 ± 16.4, P = 0.001). No significant intergroup difference was noted at the follow-up for radiographic osteoarthritic grade according to Kellgren-Lawrence classification. Similarly, no differences were found at final follow-up between saucerization only and saucerization with repair or centralization. There were no significant differences in IKDC score of repair and centralization at final follow-up.

Conclusions: Clinical outcomes in children aged <13 years was significantly better than those aged ≥13 years. Arthroscopic saucerization only or saucerization with repair or centralization for discoid meniscus was effective in improving knee function and preventing early degenerative changes during short-term follow-up periods.

Keywords: Discoid meniscus; Meniscus centralization; Meniscus repair; Saucerization; Skeletally immature.