Lu Xin, Fan Yu, Jiang Bo, Qian Jun, Yang Bo
Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Wang Fu Jing Street, Beijing, 100730, China.
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Int Orthop. 2023 Oct;47(10):2449-2455. doi: 10.1007/s00264-023-05941-4. Epub 2023 Aug 29.
Discoid lateral meniscus (DLM) is a common meniscal anatomic disorder and can cause irreversible knee consequences. The long-term clinical outcomes of DLM management remain unclear. Moreover, several potential factors would influence the long-term functional outcomes. The factors also remain unclear. This study aims to evaluate the long-term clinical outcomes of the arthroscopic management of the DLM and to identify the patients' factors affecting the long-term results.
Medical records were retrospectively examined for patients with symptomatic unilateral DLM who underwent arthroscopic procedures between January 2004 and August 2011. The characteristics of DLM, the preoperative and the long-term postoperative visual analog scale (VAS), the International Knee Documentation Committee (IKDC) score, Lysholm, and Yulish scores were evaluated. Data were collected, processed, and analyzed using SAS software version 9.2. Univariate and multivariate analyses were performed to identify the factors influencing the long-term outcomes of the DLM arthroscopy.
A total of 128 patients were included, most of whom were females (68.7%). The median age of the included participants was 24 (16-31) years old. The median duration of symptoms was 23.3 (10, 31) months, and the median follow-up duration was 126.2 (113, 140) months. The functional scores significantly improved postoperatively compared to the preoperative scores; VAS (1.65 ± 1.17 vs. 6.08 ± 1.31), Lysholm (91.39 ± 5.05 vs. 77.51 ± 10.19), and IKDC (84.63 ± 7.69 vs. 67.89 ± 9.56), respectively; p<0.05. Multivariate analysis revealed that gender, the status of self-reported instability, preoperative VAS, Yulish MR cartilage grade, and Lysholm score had a significant correlation with the worsening of the final follow-up IKDC scores.
Arthroscopic procedure significantly improved the long-term joint function of the DLM patients, as evidenced by the sustained improvement of the VAS, Lysholm, and IKDC scores. These clinical outcomes were greatly influenced by gender, the status of self-reported instability, preoperative Yulish MR cartilage grade, VAS, and Lysholm score.
盘状外侧半月板（DLM）是一种常见的半月板解剖学紊乱，可导致不可逆的膝关节后果。DLM治疗的长期临床结果仍不明确。此外，有几个潜在因素会影响长期功能结果。这些因素也尚不明确。本研究旨在评估关节镜下治疗DLM的长期临床结果，并确定影响长期结果的患者因素。
回顾性研究2004年1月至2011年8月间接受关节镜手术的有症状单侧DLM患者的病历。评估DLM的特征、术前和术后长期的视觉模拟量表（VAS）、国际膝关节文献委员会（IKDC）评分、Lysholm评分和Yulish评分。使用SAS 9.2版软件收集、处理和分析数据。进行单因素和多因素分析以确定影响DLM关节镜检查长期结果的因素。
共纳入128例患者，其中大多数为女性（68.7%）。纳入参与者的中位年龄为24（16 - 31）岁。症状的中位持续时间为23.3（10，31）个月，中位随访时间为126.2（113，140）个月。与术前评分相比，术后功能评分显著改善；VAS评分（1.65±1.17对6.08±1.31）、Lysholm评分（91.39±5.05对77.51±10.19）和IKDC评分（84.63±7.69对67.89±9.56），p<0.05。多因素分析显示，性别、自我报告的不稳定状态、术前VAS、Yulish磁共振成像软骨分级和Lysholm评分与末次随访IKDC评分的恶化有显著相关性。
关节镜手术显著改善了DLM患者的长期关节功能，VAS、Lysholm和IKDC评分的持续改善证明了这一点。这些临床结果受性别、自我报告的不稳定状态、术前Yulish磁共振成像软骨分级、VAS和Lysholm评分的极大影响。
