Guidelines on the Diagnosis and Treatment of Lateral Meniscal Lesions: A Consensus Statement by the Chinese Society of Sports Medicine

Shurong Zhang; Gang Chen; Ruixin Li; Chunxi Yang; Jiapeng Zheng; Cheng Wang; Jun Lu; Zhengzheng Zhang; Xiliang Shang; Hui Zhang; Weiming Wang; Weiping Li; Jingmin Huang; Yadong Zhang; Jianquan Wang; You Wang; Xiaofei Zheng; Shiyi Chen; Jian Li; Yinghui Hua

doi:10.1177/23259671221138082

Guidelines on the Diagnosis and Treatment of Lateral Meniscal Lesions: A Consensus Statement by the Chinese Society of Sports Medicine

Orthop J Sports Med. 2022 Dec 9;10(12):23259671221138082. doi: 10.1177/23259671221138082. eCollection 2022 Dec.

Authors

Shurong Zhang¹, Gang Chen², Ruixin Li³, Chunxi Yang⁴, Jiapeng Zheng⁵, Cheng Wang⁶, Jun Lu⁷, Zhengzheng Zhang⁸, Xiliang Shang¹, Hui Zhang⁹, Weiming Wang³, Weiping Li⁸, Jingmin Huang¹⁰, Yadong Zhang¹¹, Jianquan Wang⁶, You Wang⁴, Xiaofei Zheng¹², Shiyi Chen¹², Jian Li², Yinghui Hua¹

Affiliations

¹ Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
² Orthopaedic Research Institution, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China.
³ Department of Sports Medicine, Dalian University Affiliated Xinhua Hospital, Dalian, Liaoning Province, China.
⁴ Department of Bone and Joint Surgery, Department of Orthopaedics, Shanghai Jiaotong University, School of Medicine, Renji Hospital, Shanghai, China.
⁵ Department of Orthopaedic Surgery, Dongnan Hospital of Xiamen University, School of Medicine, Xiamen University, Fujian Province, China.
⁶ Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China.
⁷ Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu Province, China.
⁸ Department of Orthopaedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou Province, China.
⁹ Sports Medicine Department, Beijing Jishuitan Hospital, Beijing, China.
¹⁰ Department of Sports Injuries and Arthroscopy, Tianjin Hospital, Tianjin, China.
¹¹ Department of Orthopaedics, The Fourth Medical Centre of Chinese PLA General Hospital, Beijing, China.
¹² Department of Bone and Joint Surgery and Sports Medicine Center, The First Affiliated Hospital, Jinan University, Guangzhou, China.

Abstract

Background: The lateral meniscus is a unique structure of the knee joint, and its anatomy, function, pathological process, and treatment are distinct from those of the medial meniscus. To date, no consensus on the management of lateral meniscal lesions has been published, and clinical decision-making is challenging. To facilitate this, consensus and practice guidelines for lateral meniscal lesions were developed and endorsed by the Chinese Society of Sports Medicine.

Study design: Consensus statement.

Methods: This project followed the Delphi approach to the consensus process, involving steering, rating, and peer review groups. A total of 61 experts in the fields of sports medicine and arthroscopic surgery were invited to participate in the compilation of a consensus statement on lateral meniscal lesions. (The discoid lateral meniscus was addressed by separate consensus.) To begin, the steering group drafted a set of questions and replies regarding lateral meniscal lesions. An online panel discussion was then held to provide initial agreement and comments on the statements, followed by a round of anonymous voting. Results and feedback were sent to the steering group for a second draft. A second round of voting was then held, and each statement was discussed during a combined meeting of the steering and rating groups. Finally, a consensus draft was evaluated by a review group.

Results: Fifty-three questions and answers addressing lateral meniscal lesions were drafted, and 20 statements were excluded because of redundant information during the first round of voting. Ultimately, 33 statements were completed, 9 of which were unanimous.

Conclusion: This expert consensus process focused on the anatomy, function, pathological processes, and treatment of lateral meniscal lesions. Accepted recommendations in these areas can assist doctors and therapists in standardizing the management of related pathology. The consensus statement indicates that certain types of lateral meniscal tears that were previously considered irreparable can be repaired. Preservation of the lateral meniscus should be the first-line treatment whenever possible, because the long-term clinical and radiological outcomes are worse after partial meniscectomy.

Keywords: diagnosis and treatment; expert consensus; lateral meniscus.