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- Title
Discoid lateral meniscus instability in children: part II.: Repair first to minimise the saucerisation.
- Authors
Bauwens, Paul Henri; Vandergugten, Simon; Fiquet, Charles; Raux, Sébastien; Cance, Nicolas; Chotel, Franck
- Abstract
Purpose: Despite an improved understanding of discoid lateral meniscus (DLM), the treatment of symptomatic discoid lateral meniscus remains controversial. Methods: 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. Results: 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. Conclusion: 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.
- Subjects
MENISCUS (Anatomy); MENISCECTOMY; PROGNOSIS; MENISCUS injuries; SUTURES
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2023, Vol 31, Issue 11, p4816
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-023-07538-1