Abstract
Background:
The ideal width of the residual rim after saucerization is unknown for discoid lateral meniscus patients (1).
Objectives:
Native meniscal width remaining during surgery is a necessary and sufficient condition for discoid lateral meniscus patients.
Methods:
A retrospective analysis of 77 knees with complete discoid lateral meniscus (CDLM) and a mean age of 13.2±4.2 years who underwent saucerization with or without repair was divided into three groups regarding meniscal width of midbody immediately after surgery with MRI (large group; more than 13mm, middle group; between 9 to less than 13mm, and small group; less than 9mm) and performed to assess the change over time,<50 % of the reducing rate of midbody width at 24months and the complications. The complications after surgery were defined as the presence of retear, revision surgery, and the occurrence of osteochondritis dissecans after the surgery. Demographic data (Age, sex, height, weight, Lysholm score, Tegner activity scale), type of preoperative shift, and meniscal width immediately after surgery were analyzed for their association with <50 % of the reducing rate at 24 months and complications. Logistic regression analyses were used.
Results:
Midbody meniscal width of high, middle, and low groups at 0 and 24 months were 14.5±1.5, 10.8±1.1 and 7.5±0.9mm, 6.3±2.4, 6.5±1.8, and 4.6±1.2mm, respectively. The midbody meniscal width of the low group at 24 months was lower than that of the high and middle groups, with no significant difference between the high and middle groups. The reducing rate of midbody from 0 to 24 months in the high group was higher than in the middle and low groups. There was no significant difference in postoperative Lysholm score and TAS between the three groups. However, the complication rate of the high group was significantly higher than that of the middle and low groups. On multivariate analyses, higher midbody meniscal width at 0 months was a risk factor for <50 % of the reducing rate of midbody width at 24 months. Receiver operating characteristic curve analysis revealed a cutoff value of midbody meniscal width at 0 months of 10.8mm. High activity was a risk factor for complications after surgery.
Conclusion:
Middle range (9-13mm) residual meniscus of midbody immediately after surgery remained the same meniscal width as the high group, with low complication at 24 months after surgery. High activity patients was a risk factor for complications of retear, revision, and postoperative OCD.