Arthroscopic management of discoid lateral meniscus in children: 5-Year minimum follow-up clinical outcome.

Abstract

Purpose: We investigated the medium-term clinical results and revision rate of arthroscopic rim-preserving saucerization for symptomatic lateral discoid meniscus in children.

Methods: A single-centre, retrospective study was conducted on patients treated with arthroscopy for symptomatic discoid lateral meniscus between December 2005 and May 2019. Eligibility criteria were patients <16 years at the time of surgery and a minimum follow-up of 5 years. Preoperative data (age, sex, symptoms and physical examination), arthroscopic findings (Watanabe and Ahn classifications, meniscal instability and the presence of meniscal tear), treatment (saucerization ± stabilization ± meniscal repair), patient-reported outcome measurements (Lysholm, Tegner and Ikeuchi scores) and arthroscopic revision rate were recorded.

Results: In all, 47 (72%) of the 65 eligible patients replied to the questionnaires and were therefore included (9 bilateral cases). The mean age at the time of surgery was 8.6 ± 3.3 years. Patient-reported scores were all improved after a mean follow-up of 10.5 years (5-15.9): Ikeuchi (64.2% excellent-good versus 3.6%), Lysholm (90.5 versus 72.9) and Tegner (5 versus 4.3). Two patients developed osteochondritis dissecans of the lateral femoral condyle which healed following non-operative measures. There was no other complication. An arthroscopic revision was performed in 10 patients (17.9%) after a mean follow-up of 2.7 years.

Conclusion: The medium-term results of rim-preserving arthroscopic saucerization are favourable, yet with a substantial arthroscopic revision rate. Risk factors for failure and revision should be further investigated.