Arthroscopic Management for the Symptomatic Discoid Lateral Meniscus

ABSTRACT

PURPOSE: Retrospective study was performed about the incidence, type and pattern of tears, and clini-cal results after arthroscopic management for the symptomatic discoid lateral meniscus. MATERIALS AND METHODS: 54 cases in 49 patients who were managed arthroscopically and followed up for minimum one year for the symptomatic discoid lateral meniscus from Sept. 1993 to Aug. 1998 were included. Mean age at the time of surgery was 30.9 years(ranged, 12-63), most commonly in the second decade(42.5%) and mean duration of symptoms was 22.2 months. Females were more commonly affected than males(25 males and 29 females), and right knees were involved in 25 cases, left knees in 19 cases and bilateral in 5 cases. Most common symptoms was pain in 83.3% and snapping sound in 43.3%. The cause of symptoms was mostly related to previous trauma or sports injury in 66.7%, but none in 18 cases(33.3%). Discoid meniscus was classified according to the Watanabe's classification system and tears were classified as a transverse, longitudinal, horizontal with cystic degeneration, peripheral, wear in the inferior surface and complex. All the partial meniscectomies were done by a piecemeal fashion and the menisci were sutured in a vertical and horizontal way by inside-out or outside-in technique on the basis of day surgery. Postoperative regimens of the immediate passive and active ROM and quadriceps setting exercises were prescribed, and mean follow-up was 31.7 months(ranged, 12-62). RESULTS: According to the Ikeuchi's scale(1969), overall 83.4% of good or excellent clinical results were obtained and poor in 2 cases. Among 5 cases of retear, 3 cases showed excellent clinical results after the second arthroscopic treatment, and 1 case was fair, but 1 case progressed to arthrofibrosis which was rated poor result, and in another one case of poor result without retear, persistent pain was complained due to preexisting osteoarthrosis. CONCLUSIONS: Arthroscopic partial meniscectomy or reshaping is recommmended for the symptomatic discoid lateral meniscus tears in children and adults, but more long-term follow-up and its clinical results about the treatment method in children and adults will be needed.