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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2020

01-12-2020 | Arthroscopy | Research article

Factors influencing postoperative outcomes in patients with symptomatic discoid lateral meniscus

Authors: Shun-Jie Yang, Zhong-Jun Ding, Jian Li, Yang Xue, Gang Chen

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; however, postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM.

Methods

Patients with DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were enrolled according to the inclusion and exclusion criteria. Fourteen variables, including sex, body mass index (BMI) and other variables, were chosen as factors for study. Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Univariate analyses (Mann-Whitney U test or Kruskall-Wallis rank sum test) and multivariate analyses (ordinal logistic regression) were used to identify the factors that influenced postoperative outcomes. P < 0.05 was considered statistically significant.

Results

A total of 502 patients, including 353 females (70.3%) and 149 males (29.7%), were enrolled. The median IKDC score postoperatively (87.4; range, 41.4 ~ 97.7; IQR, 14.6) was higher than that preoperatively (57.6; range, 26.9 ~ 64.9; IQR, 9.7) (P < 0.001). Male sex was predictive of a higher IKDC score (P = 0.023, OR = 1.702). Compared with BMI ≥25 kg/m2, < 18.5 kg/m2 was associated with better IKDC score (P = 0.026, OR = 3.016). Contrasting with age of onset ≥45 years, ≤14 years (P < 0.001, OR = 20.780) and 14 ~ 25 years (P < 0.001, OR = 8.516) were associated with better IKDC score. In comparison with symptoms duration> 24 months, IKDC scores for patients with symptoms duration ≤1 month (P = 0.001, OR = 3.511), 1 ~ 6 months (P < 0.001, OR = 3.463) and 6 ~ 24 months (P < 0.001, OR = 3.254) were significantly elevated. Compared to Outerbridge grade III ~ IV, no injury (P < 0.001, OR = 6.379) and grade I (P = 0.01, OR = 4.332) were associated with higher IKDC score.

Conclusions

Arthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5 kg/m2, age of onset < 25 years (especially < 14 years) and symptoms duration < 24 months are conducive to good postoperative outcomes. However, combined articular cartilage injury (Outbridge grade ≥ 2) reduces postoperative effect.
Literature
1.
Kocher MS, Logan CA, Kramer DE. Discoid lateral meniscus in children: diagnosis, management, and outcomes. J Am Acad Orthop Surg. 2017;25:736–43.PubMedCrossRef
2.
Masquijo JJ, Bernocco F, Porta J. Discoid meniscus in children and adolescents: correlation between morphology and meniscal tears. Rev Esp Cir Ortop Traumatol. 2019;63:24–8.PubMed
3.
Papadopoulos A, Kirkos JM, Kapetanos GA. Histomorphologic study of discoid meniscus. Arthroscopy. 2009;25:262–8.PubMedCrossRef
4.
Fukuta S, Masaki K, Korai F. Prevalence of abnormal findings in magnetic resonance images of asymptomatic knees. J Orthop. 2002;7:287–91.
5.
Ikeuchi H. Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results. Clin Orthop Relat Res. 1982:19–28.
6.
Kim SJ, Lee YT, Kim DW. Intraarticular anatomic variants associated with discoid meniscus in Koreans. Clin Orthop Relat Res. 1998;356:202–7.CrossRef
7.
Rao PS, Rao SK, Paul R. Clinical, radiologic, and arthroscopic assessment of discoid lateral meniscus. Arthroscopy. 2001;17:275–7.PubMedCrossRef
8.
9.
Lee SH. Editorial commentary: why should the contralateral side be examined in patients with symptomatic discoid lateral meniscus? Arthroscopy. 2019;35:507–10.PubMedCrossRef
10.
Chen LX, Ao YF, Yu JK, Miao Y, Leung KK, Wang HJ, Lin L. Clinical features and prognosis of discoid medial meniscus. Knee Surg Sports Traumatol Arthrosc. 2013;21:398–402.PubMedCrossRef
11.
Lee CR, Bin SI, Kim JM, Lee BS, Kim NK. Arthroscopic partial meniscectomy in young patients with symptomatic discoid lateral meniscus: an average 10-year follow-up study. Arch Orthop Trauma Surg. 2018;138:369–76.PubMedCrossRef
12.
Chen H-C, Yang C-B, Tsai C-F, Ma H-L, Liu C-L, Huang T-F. Management and outcome of discoid meniscus tears. Formosan J Musculoskelet Disord. 2011;2:45–8.CrossRef
13.
Fu D, Guo L, Yang L, Chen G, Duan X. Discoid lateral meniscus tears and concomitant articular cartilage lesions in the knee. Arthroscopy. 2014;30:311–8.PubMedCrossRef
14.
Persiani P, Mariani M, Crostelli M, Mascello D, Mazza O, Ranaldi FM, Martini L, Villani C. Can early diagnosis and partial meniscectomy improve quality of life in patients with lateral discoid meniscus? Clin Ter. 2013;164:e359–64.PubMed
15.
Chen G, Zhang Z, Li J. Symptomatic discoid lateral meniscus: a clinical and arthroscopic study in a Chinese population. BMC Musculoskelet Disord. 2016;17:329.PubMedPubMedCentralCrossRef
16.
Habata T, Uematsu K, Kasanami R, Hattori K, Takakura Y, Tohma Y, Fujisawa Y. Long-term clinical and radiographic follow-up of total resection for discoid lateral meniscus. Arthroscopy. 2006;22:1339–43.PubMedCrossRef
17.
Kose O, Celiktas M, OF E, Guler F, Ozyurek S, Sarpel Y. Prognostic factors affecting the outcome of arthroscopic saucerization in discoid lateral meniscus: a retrospective analysis of 48 cases. Musculoskelet Surg. 2015;99:165–70.PubMedCrossRef
18.
Kraus TM, Abele C, Freude T, Ateschrang A, Stockle U, Stuby FM, Schroter S. Duration of incapacity of work after tibial plateau fracture is affected by work intensity. BMC Musculoskelet Disord. 2018;19:281.PubMedPubMedCentralCrossRef
19.
Shahriaree H. O’Conner’s textbook of arthroscopic surgery. Philadelphia: Lippincott; 1992.
20.
Rodriguez-Merchan EC, Gomez-Cardero P. The outerbridge classification predicts the need for patellar resurfacing in TKA. Clin Orthop Relat Res. 2010;468:1254–7.PubMedCrossRef
21.
Schiphof D, Boers M, Bierma-Zeinstra SM. Differences in descriptions of Kellgren and Lawrence grades of knee osteoarthritis. Ann Rheum Dis. 2008;67:1034–6.PubMedCrossRef
22.
Hefti F, Muller W, Jakob RP, Staubli HU. Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc. 1993;1:226–34.CrossRef
23.
Ahn JY, Kim TH, Jung BS, Ha SH, Lee BS, Chung JW, Kim JM, Bin SI. Clinical results and prognostic factors of arthroscopic surgeries for discoid lateral menisci tear: analysis of 179 cases with minimum 2 years follow-up. Knee Surg Relat Res. 2012;24:108–12.PubMedPubMedCentralCrossRef
24.
Hanna FS, Teichtahl AJ, Wluka AE, Wang Y, Urquhart DM, English DR, Giles GG, Cicuttini FM. Women have increased rates of cartilage loss and progression of cartilage defects at the knee than men: a gender study of adults without clinical knee osteoarthritis. Menopause. 2009;16:666–70.PubMedCrossRef
25.
Cho HJ, Chang CB, Yoo JH, Kim SJ, Kim TK. Gender differences in the correlation between symptom and radiographic severity in patients with knee osteoarthritis. Clin Orthop Relat Res. 2010;468:1749–58.PubMedPubMedCentralCrossRef
26.
Cicuttini F, Forbes A, Morris K, Darling S, Bailey M, Stuckey S. Gender differences in knee cartilage volume as measured by magnetic resonance imaging. Osteoarthr Cartil. 1999;7:265–71.PubMedCrossRef
27.
Wong T, Wang CJ. Functional analysis on the treatment of torn discoid lateral meniscus. Knee. 2011;18:369–72.PubMedCrossRef
28.
Ahn JH, Kang DM, Choi KJ. Risk factors for radiographic progression of osteoarthritis after partial meniscectomy of discoid lateral meniscus tear. Orthop Traumatol Surg Res. 2017;103:1183–8.PubMedCrossRef
29.
Ding J, Zhao J, He Y, Huangfu X, Zeng B. Risk factors for articular cartilage lesions in symptomatic discoid lateral meniscus. Arthroscopy. 2009;25:1423–6.PubMedCrossRef
30.
Kim SJ, Bae JH, Lim HC. Does torn discoid meniscus have effects on limb alignment and arthritic change in middle-aged patients? J Bone Joint Surg Am. 2013;95:2008–14.PubMedCrossRef
31.
Zhang P, Zhao Q, Shang X, Wang Y. Effect of arthroscopic resection for discoid lateral meniscus on the axial alignment of the lower limb. Int Orthop. 2018;42:1897–903.PubMedCrossRef
32.
Englund M, Felson DT, Guermazi A, Roemer FW, Wang K, Crema MD, Lynch JA, Sharma L, Segal NA, Lewis CE, Nevitt MC. Risk factors for medial meniscal pathology on knee MRI in older US adults: a multicentre prospective cohort study. Ann Rheum Dis. 2011;70:1733–9.PubMedPubMedCentralCrossRef
33.
34.
35.
Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop Relat Res. 2001:S362–9.
36.
Higuchi H, Kimura M, Shirakura K, Terauchi M, Takagishi K. Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res. 2000:161–8.
37.
Amin S, LaValley MP, Guermazi A, Grigoryan M, Hunter DJ, Clancy M, Niu J, Gale DR, Felson DT. The relationship between cartilage loss on magnetic resonance imaging and radiographic progression in men and women with knee osteoarthritis. Arthritis Rheum. 2005;52:3152–9.PubMedCrossRef
38.
Bin SI, Jeong SI, Kim JM, Shon HC. Arthroscopic partial meniscectomy for horizontal tear of discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc. 2002;10:20–4.PubMedCrossRef
39.
Kim SJ, Chun YM, Jeong JH, Ryu SW, Oh KS, Lubis AM. Effects of arthroscopic meniscectomy on the long-term prognosis for the discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc. 2007;15:1315–20.PubMedCrossRef
40.
Stilli S, Marchesini Reggiani L, Marcheggiani Muccioli GM, Cappella M, Donzelli O. Arthroscopic treatment for symptomatic discoid lateral meniscus during childhood. Knee Surg Sports Traumatol Arthrosc. 2011;19:1337–42.PubMedCrossRef
41.
Ahn JH, Lee SH, Yoo JC, Lee YS, Ha HC. 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;24:888–98.PubMedCrossRef
42.
Smuin DM, Swenson RD, Dhawan A. Saucerization versus complete resection of a symptomatic discoid lateral meniscus at short- and long-term follow-up: a systematic review. Arthroscopy. 2017;33:1733–42.PubMedCrossRef
43.
Ahn JH, Kim KI, Wang JH, Jeon JW, Cho YC, Lee SH. Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthroscopy. 2015;31:867–73.PubMedCrossRef
44.
Lee YS, Teo SH, Ahn JH, Lee OS, Lee SH, Lee JH. Systematic review of the long-term surgical outcomes of discoid lateral meniscus. Arthroscopy. 2017;33:1884–95.PubMedCrossRef
45.
Lee DH, D'Lima DD, Lee SH. Clinical and radiographic results of partial versus total meniscectomy in patients with symptomatic discoid lateral meniscus: a systematic review and meta-analysis. Orthop Traumatol Surg Res. 2019;105:669–75.PubMedCrossRef
46.
Atay OA, Doral MN, Leblebicioglu G, Tetik O, Aydingoz U. Management of discoid lateral meniscus tears: observations in 34 knees. Arthroscopy. 2003;19:346–52.PubMedCrossRef
47.
Zhang Z, Shang XK, Mao BN, Li J, Chen G. Torn discoid lateral meniscus is associated with increased medial meniscal extrusion and worse articular cartilage status in older patients. Knee Surg Sports Traumatol Arthrosc. 2019;27:2624–31.PubMedCrossRef
48.
Badlani JT, Borrero C, Golla S, Harner CD, Irrgang JJ. The effects of meniscus injury on the development of knee osteoarthritis: data from the osteoarthritis initiative. Am J Sports Med. 2013;41:1238–44.PubMedCrossRef
49.
Shahrezaee M, Maheronnaghsh R, Hashemitaheri A, Chavoshi M. Proximal Tibiofibular joint inclination angle and associated meniscal tear in patients with discoid lateral meniscus. Maedica. 2019;14:116–20.PubMedPubMedCentral
Metadata
Title
Factors influencing postoperative outcomes in patients with symptomatic discoid lateral meniscus
Authors
Shun-Jie Yang
Zhong-Jun Ding
Jian Li
Yang Xue
Gang Chen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03573-y

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