Clinical outcomes as a function of meniscal stability in the discoid meniscus: a preliminary report.
Academic Article
Overview
abstract
BACKGROUND: Current treatment for discoid meniscus includes arthroscopic saucerization, with meniscal stabilization additionally performed in patients with demonstrated instability. It is thought that unstable discoid menisci represent a more severe variant and are therefore at risk for poorer clinical outcomes. Our hypothesis was that there is no difference in clinical outcomes between patients undergoing discoid meniscal saucerization alone and those who additionally require stabilization. METHODS: A retrospective chart review was performed for all patients presenting to a single pediatric center for treatment of a symptomatic discoid meniscus. Data collected included sex, age, affected side(s), preoperative and postoperative range of motion (ROM), type of surgery, and the presence of postoperative complications. In addition, a subset of these patients was enrolled prospectively. These patients completed 3 self-assessment tools-the International Knee Documentation Committee questionnaire, Lysholm Knee Score, and Tegner Activity Scale-before and after surgical intervention. Outcomes measures included objective criteria (ROM and surgical complications) and subjective criteria (patient-reported functional outcomes). For all outcomes measures, the Fisher exact test was used to determine whether significant differences existed between the patients who had undergone saucerization only and those who had also required surgical stabilization. RESULTS: Fifty-seven knees in 51 patients were included in the study. Thirty-three patients (58%) underwent saucerization alone and 24 (42%) underwent saucerization and stabilization. Six surgical complications were identified. There was no significant difference between the groups regarding patient-specific factors (sex, age, and affected side) and postoperative outcomes measures (ROM and complication rate). Average patient follow-up was 15 months postoperatively. Seventeen patients (17 knees) additionally completed the 3 self-assessment questionnaires. In this subset of patients followed prospectively, there was no significant difference in self-reported outcomes detected between the meniscal saucerization and meniscal repair groups. CONCLUSIONS: Short-term results for patients with symptomatic discoid menisci requiring surgical intervention are favorable. The addition of a meniscal stabilization step to the saucerization procedure does not negatively affect either early clinical outcomes or complication rates in patients with demonstrated meniscal instability. LEVEL OF EVIDENCE: Level III: Therapeutic Study, Retrospective, Comparative.
