Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2015
Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Ahn Jin Hwan, Kim Kang-Il, Wang Joon Ho, Jeon Jong Wook, Cho Young Chu, Lee Sang Hak
Аннотация
PURPOSE: To assess the long-term clinical and radiographic results of arthroscopic reshaping with or without peripheral meniscus repair for the treatment of symptomatic discoid lateral meniscus in children.
METHODS: This study included 38 children (48 knees) who underwent arthroscopic surgery for symptomatic discoid lateral meniscus. The mean age at operation was 9.9 years (range, 4 to 15 years), and the mean follow-up period was 10.1 years (range, 8 to 14 years). Arthroscopic partial meniscectomy was performed in 22 knees (group A); partial meniscectomy with repair, in 18 knees (group B); and subtotal meniscectomy, in 8 knees (group C). Clinical and radiographic results were evaluated preoperatively and at the final follow-up.
RESULTS: According to the scale of Ikeuchi, 94% of cases showed excellent or good results clinically. At the final follow-up, the median Tegner activity level was 7 (range, 4 to 10). The mean Lysholm knee score improved from 74.9 ± 10.6 to 97.6 ± 4.0, and the mean Hospital for Special Surgery score improved from 80.8 ± 8.9 to 97.8 ± 3.6 (P < .0001). At the final follow-up, radiographic evaluation showed the development of minor osteophytes in the lateral compartment of 18 knees and moderate joint space narrowing with spur formation in 1 knee. In addition, degenerative changes were observed in 23% of cases in group A, 39% of cases in group B, and 88% of cases in group C. Group C showed significantly greater progression of degenerative changes than group A or B.
CONCLUSIONS: Arthroscopic reshaping for symptomatic discoid lateral meniscus in children led to satisfactory clinical outcomes after a mean of 10.1 years. However, progressive degenerative changes appeared in 40% of the patients. The subtotal meniscectomy group had significantly increased degenerative changes compared with partial meniscectomy with or without repair.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
METHODS: This study included 38 children (48 knees) who underwent arthroscopic surgery for symptomatic discoid lateral meniscus. The mean age at operation was 9.9 years (range, 4 to 15 years), and the mean follow-up period was 10.1 years (range, 8 to 14 years). Arthroscopic partial meniscectomy was performed in 22 knees (group A); partial meniscectomy with repair, in 18 knees (group B); and subtotal meniscectomy, in 8 knees (group C). Clinical and radiographic results were evaluated preoperatively and at the final follow-up.
RESULTS: According to the scale of Ikeuchi, 94% of cases showed excellent or good results clinically. At the final follow-up, the median Tegner activity level was 7 (range, 4 to 10). The mean Lysholm knee score improved from 74.9 ± 10.6 to 97.6 ± 4.0, and the mean Hospital for Special Surgery score improved from 80.8 ± 8.9 to 97.8 ± 3.6 (P < .0001). At the final follow-up, radiographic evaluation showed the development of minor osteophytes in the lateral compartment of 18 knees and moderate joint space narrowing with spur formation in 1 knee. In addition, degenerative changes were observed in 23% of cases in group A, 39% of cases in group B, and 88% of cases in group C. Group C showed significantly greater progression of degenerative changes than group A or B.
CONCLUSIONS: Arthroscopic reshaping for symptomatic discoid lateral meniscus in children led to satisfactory clinical outcomes after a mean of 10.1 years. However, progressive degenerative changes appeared in 40% of the patients. The subtotal meniscectomy group had significantly increased degenerative changes compared with partial meniscectomy with or without repair.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.