Mohan Kriti, Bharti Ajay, Kumar Manish, Kumar Nitish, Kumar Vivek, Kumar Rajnand, Kushwaha Sudhir Shyam
Department of Orthopaedics, Department of Paediatrics, AIIMS, Gorakhpur, Gorakhpur, UP 273008 India.
Indian J Orthop. 2024 Apr 24;58(6):619-636. doi: 10.1007/s43465-024-01137-z. eCollection 2024 Jun.
This study aimed to reach a consensus for ideal surgical treatment of discoid lateral meniscus (DLM) and to evaluate its long term surgical and radiological outcome.
All authors independently searched for peer reviewed publications with keywords like discoid lateral meniscus, tibial menisci abnormalities, tibial menisci surgery and clinical outcome and their representative Medical Subjects Headings (MeSH) in databases of PubMed, EBSCO, Cochrane Central Register of Controlled Trials, from inception to December 2022. Original articles in English language on discoid lateral meniscus reporting clinical, surgical, or radiological outcomes with five or more years of follow-up were included in this systematic review. Study details and outcome data were analysed according to the age, follow-up period, kind of surgery, DLM type, and alignment.
Our search strategy yielded 654 articles in PubMed, 222 articles in EBSCO and 5 articles in CENTRAL i.e. a total of 881 articles. After detailed assessment and screening, 12 articles were included in the final analysis, which included 444 DLM cases. The mean patient age at surgery ranged from 9.9 to 35.9 years, and the mean follow-up period ranged from 5.2 to 16 years. Partial meniscectomy and meniscoplasty are the recommended treatment because of the concerns of degenerative arthritis development after the total and subtotal meniscectomies. Two studies have documented better results with meniscal allograft transplantation.
Satisfactory clinico-radiological outcome can be obtained after surgical treatment of discoid lateral meniscus with meniscus reshaping and repair of peripheral unstable part. Meniscal allograft transplantation (MAT) is gaining popularity in patients with total meniscectomy with satisfactory long term functional outcome.
本研究旨在就盘状外侧半月板（DLM）的理想手术治疗达成共识，并评估其长期手术和影像学结果。
所有作者独立检索了PubMed、EBSCO、Cochrane对照试验中央登记库等数据库中从建库至2022年12月期间的同行评审出版物，检索关键词如盘状外侧半月板、胫骨半月板异常、胫骨半月板手术和临床结果及其代表性医学主题词（MeSH）。本系统评价纳入了英文撰写的关于盘状外侧半月板的原创文章，这些文章报告了五年或更长时间随访后的临床、手术或影像学结果。根据年龄、随访时间、手术类型、DLM类型和对线情况对研究细节和结果数据进行了分析。
我们的检索策略在PubMed中检索到654篇文章，在EBSCO中检索到222篇文章，在CENTRAL中检索到5篇文章，共计881篇文章。经过详细评估和筛选，最终分析纳入了12篇文章，其中包括444例DLM病例。手术时患者的平均年龄在9.9至35.9岁之间，平均随访时间在5.2至16年之间。由于担心全半月板切除术和次全半月板切除术后发生退行性关节炎，部分半月板切除术和半月板成形术是推荐的治疗方法。两项研究记录了半月板同种异体移植取得了更好的结果。
通过半月板重塑和修复外周不稳定部分对盘状外侧半月板进行手术治疗后，可获得满意的临床影像学结果。半月板同种异体移植（MAT）在全半月板切除患者中越来越受欢迎，长期功能结果令人满意。
