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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 2008 August
PURPOSE: This study was undertaken to document the clinical results and technical aspects of arthroscopic partial meniscectomy in conjunction with peripheral tear repair for the treatment of symptomatic discoid lateral meniscus in children.
METHODS: From June 1998 to May 2005, the senior author (J.H.A.) performed arthroscopic surgery on 77 children (89 knees) with symptomatic discoid lateral meniscus. Of these patients, we retrospectively studied 23 patients (28 knees) with a peripheral tear that was treated by partial central meniscectomy in conjunction with peripheral suture repair. Mean age at operation was 9.0 years (range, 4 to 15 years), and the mean follow-up period was 50.9 months (range, 24 to 94 months). Arthroscopic findings were categorized into 3 types in terms of peripheral rim stability and tear site: (1) meniscocapsular junction (MC), anterior horn type (MC-A type); (2) MC, posterior horn type (MC-P type); and (3) posterolateral corner (PLC) loss type. These 3 types needed different arthroscopic techniques for saucerization with repair. Clinical results were evaluated using Lysholm knee scores and Hospital for Special Surgery (HSS) scores preoperatively and at final follow-up.
RESULTS: All patients were able to return to their previous life activities with little or no limitation, and no reoperation was required after an average follow-up of 51 months. Mean Lysholm knee scores improved from 78.5 (range, 69 to 89) preoperatively to 95.5 (range, 85 to 100) at the final follow-up (P < .0001), and the mean HSS score improved from 80.3 (range, 69 to 89) preoperatively to 95.9 (range, 90 to 100) at the final follow-up (P < .0001).
CONCLUSIONS: We believe that the described arthroscopic partial meniscectomy in conjunction with the meniscal repair of the peripheral tear are effective for treating children with a symptomatic discoid lateral meniscus.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
METHODS: From June 1998 to May 2005, the senior author (J.H.A.) performed arthroscopic surgery on 77 children (89 knees) with symptomatic discoid lateral meniscus. Of these patients, we retrospectively studied 23 patients (28 knees) with a peripheral tear that was treated by partial central meniscectomy in conjunction with peripheral suture repair. Mean age at operation was 9.0 years (range, 4 to 15 years), and the mean follow-up period was 50.9 months (range, 24 to 94 months). Arthroscopic findings were categorized into 3 types in terms of peripheral rim stability and tear site: (1) meniscocapsular junction (MC), anterior horn type (MC-A type); (2) MC, posterior horn type (MC-P type); and (3) posterolateral corner (PLC) loss type. These 3 types needed different arthroscopic techniques for saucerization with repair. Clinical results were evaluated using Lysholm knee scores and Hospital for Special Surgery (HSS) scores preoperatively and at final follow-up.
RESULTS: All patients were able to return to their previous life activities with little or no limitation, and no reoperation was required after an average follow-up of 51 months. Mean Lysholm knee scores improved from 78.5 (range, 69 to 89) preoperatively to 95.5 (range, 85 to 100) at the final follow-up (P < .0001), and the mean HSS score improved from 80.3 (range, 69 to 89) preoperatively to 95.9 (range, 90 to 100) at the final follow-up (P < .0001).
CONCLUSIONS: We believe that the described arthroscopic partial meniscectomy in conjunction with the meniscal repair of the peripheral tear are effective for treating children with a symptomatic discoid lateral meniscus.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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