From Surgery to Sports Career: The Long-Term Fate of Athletes With Discoid Meniscus.

OBJECTIVE

This study aimed to evaluate the long-term effectiveness of different surgical techniques for discoid meniscus in athletes.

DESIGN

This retrospective cohort study included 44 athletes (51 knees) who underwent arthroscopic surgery for symptomatic discoid meniscus between 1996 and 2019.

SETTING

The study was conducted at a tertiary-level sports medicine center.

PATIENTS: Athletes aged 15 to 35 years with symptomatic discoid meniscus confirmed by magnetic resonance imaging and requiring surgical treatment were included. Exclusion criteria were cartilage injuries (Outerbridge grades 3-4), concomitant ligament injuries requiring surgery, osteochondritis dissecans, and prior knee surgery.

INTERVENTIONS: Patients underwent arthroscopic partial, subtotal, or total meniscectomy, with or without meniscus repair.

MAIN OUTCOME MEASURES: Functional outcomes were assessed using Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lysholm scores. Osteoarthritis progression was evaluated using the Kellgren-Lawrence classification. Return to sports time and total career duration were also recorded and compared between the surgical groups.

RESULTS

The mean follow-up was 13.5 ± 6.2 years (range: 5-27 years). At the final follow-up, 72% of the meniscus-preserving group (partial meniscectomy and repair) had KL grade 0 osteoarthritis, whereas 38% of the subtotal/total meniscectomy group developed KL grades 3 to 4 osteoarthritis ( P < 0.001). All groups showed significant postoperative functional improvements ( P < 0.001), but career duration and return to play time were significantly longer in the meniscus-preserving group ( P = 0.004, P < 0.001, respectively).

CONCLUSIONS

Subtotal/total meniscectomy significantly accelerates osteoarthritis progression. Meniscus-preserving techniques provide better long-term outcomes.