Jackson Taylor, Fabricant Peter D, Beck Nicholas, Storey Eileen, Patel Neeraj M, Ganley Theodore J
Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Sports Medicine and Performance Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Orthop J Sports Med. 2019 Dec 20;7(12):2325967119890325. doi: 10.1177/2325967119890325. eCollection 2019 Dec.
Meniscal injuries in children continue to increase, which may be attributable to increasing levels of athletic participation and may be associated with additional injuries or need for additional surgeries.
To better understand the patterns of pediatric meniscal injuries by analyzing tear location, morphologic features, and associated injury patterns over a 16-year period.
Case series; Level of evidence, 4.
Pediatric patients were identified and were included in the study if age at the time of initial surgery for meniscal tear was between 5 and 14 years for female patients and 5 and 16 years for male patients. Patients were observed until age 18, and any subsequent surgeries were noted. Demographic factors, tear type and location, associated injuries, and treatment type were analyzed.
Mean patient age at surgery was 13.3 years, and 37% of patients were female. A total of 1040 arthroscopic meniscal surgeries in 880 pediatric patients were evaluated. There were 160 reoperations in 138 patients, representing a reoperation rate of 15%. These included 98 reoperations on the ipsilateral knee in 88 patients and 62 operations for injuries to the contralateral knee in 50 patients; 53% of surgeries were meniscal repair, as opposed to partial meniscectomy, and the most common technique was an all-inside repair (91%). Significant differences were identified between male and female patients. Male patients were more likely to have lateral meniscus (74% vs 65%), posterior horn (71% vs 60%), peripheral (45% vs 30%), and vertical tears (31% vs 21%); concomitant ACL injury (50% vs 40%); and an associated osteochondritis dissecans lesion (7% vs 4%). Female patients were more likely to have medial meniscus (24% vs 17%), anterior horn (25% vs 15%), and degenerative tears (34% vs 26%); discoid meniscus (33% vs 24%); and isolated meniscal tears (47% vs 33%).
This evaluation of a large series of patients has helped characterize injury patterns associated with pediatric meniscal surgeries. Most meniscal tears were repaired (53%) and were associated with additional injuries (62%), especially anterior cruciate ligament injuries (48%). More than 25% of patients had a discoid meniscus. Injury patterns differed significantly between male and female patients.
儿童半月板损伤的发生率持续上升，这可能归因于运动参与度的增加，并且可能与其他损伤或额外手术需求相关。
通过分析16年间半月板撕裂的位置、形态特征及相关损伤模式，更好地了解儿童半月板损伤的情况。
病例系列研究；证据等级为4级。
确定儿科患者，纳入标准为初次半月板撕裂手术时女性患者年龄在5至14岁之间，男性患者年龄在5至16岁之间。对患者进行随访至18岁，并记录任何后续手术情况。分析人口统计学因素、撕裂类型和位置、相关损伤及治疗类型。
手术时患者的平均年龄为13.3岁，37%为女性。共评估了880例儿科患者的1040例关节镜下半月板手术。138例患者进行了160次再次手术，再次手术率为15%。其中包括88例患者同侧膝关节的98次再次手术和50例患者对侧膝关节损伤的62次手术；53%的手术为半月板修复，而非部分半月板切除术，最常用的技术是全内修复（91%）。男性和女性患者之间存在显著差异。男性患者更易出现外侧半月板损伤（74%对65%）、后角损伤（71%对60%）、周边损伤（45%对30%）和垂直撕裂（31%对21%）；合并前交叉韧带损伤（50%对40%）；以及相关的剥脱性骨软骨炎病变（7%对4%）。女性患者更易出现内侧半月板损伤（24%对17%）、前角损伤（25%对15%）和退变性撕裂（34%对26%）；盘状半月板（33%对24%）；以及孤立性半月板撕裂（47%对33%）。
对大量患者的评估有助于明确与儿童半月板手术相关的损伤模式。大多数半月板撕裂进行了修复（53%），且与其他损伤相关（62%），尤其是前交叉韧带损伤（48%）。超过25%的患者存在盘状半月板。男性和女性患者的损伤模式存在显著差异。
