Aksoy Taha, Goymen Ibrahim Mehmet, Huri Gazi, Turhan Egemen, Kocher Mininder S, Atay Ozgur Ahmet
Department of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Orthopedics and Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Am J Sports Med. 2025 Mar;53(4):817-825. doi: 10.1177/03635465241313137. Epub 2025 Jan 29.
A discoid lateral meniscus (DLM) is the most common meniscus variant and is commonly treated with arthroscopic saucerization. There are mixed data regarding long-term results after surgery, especially in terms of radiological parameters.
PURPOSE/HYPOTHESIS: The aim was to evaluate the functional and radiological results of patients who underwent arthroscopic saucerization for a symptomatic DLM. It was hypothesized that successful outcomes can be achieved by avoiding excessive resection while reshaping only to an extent that prevents mechanical symptoms.
Case series; Level of evidence, 4.
This study retrospectively analyzed pediatric and adult patients who had a symptomatic discoid meniscus between 2000 and 2018, who underwent arthroscopic saucerization with at least 10 mm of peripheral length, and who had at least 5 years of follow-up. Radiological parameters were measured on both preoperative and follow-up radiographs. Patient-reported outcome measure scores were recorded at follow-up.
The study included 57 knees of 53 patients (mean age, 27.6 years [range, 6-65 years]). The mean follow-up duration was 12.1 years (range, 5.0-23.1 years). There were 31 knees in the pediatric group and 26 knees in the adult group. No significant difference was found between the groups or between preoperative and follow-up values for the femorotibial angle ( > .05). When the preoperative and follow-up Kellgren-Lawrence grades were compared, no change was observed in the pediatric group ( = .125), while grades were shown to progress in the adult group ( < .001). The mean Lysholm score was 94.61 ± 7.61 and 84.23 ± 14.90 for the pediatric and adult groups, respectively ( = .001). Overall, 2 patients underwent arthroscopic surgery because of a symptomatic recurrence of symptoms, and 2 patients underwent arthroplasty because of osteoarthritis. The 10-year survival rate was 90.6%.
Limited saucerization of a DLM helped to preserve coronal-plane knee joint alignment. Functional and radiological results were superior in the pediatric patients. Even when alignment was more varus in older patients, preoperative and follow-up femorotibial angles were not statistically significant. This outcome may be used to guide treatment in appropriately selected cases.
盘状外侧半月板（DLM）是最常见的半月板变异，通常采用关节镜下盘状成形术治疗。关于手术后的长期结果，尤其是放射学参数方面，数据存在差异。
目的/假设：目的是评估因有症状的DLM接受关节镜下盘状成形术患者的功能和放射学结果。假设通过避免过度切除，仅在防止机械症状的程度上进行重塑，可取得成功的结果。
病例系列；证据等级，4级。
本研究回顾性分析了2000年至2018年间因有症状的盘状半月板而接受关节镜下盘状成形术、外周长度至少为10毫米且随访至少5年的儿童和成人患者。在术前和随访X线片上测量放射学参数。在随访时记录患者报告的结局测量评分。
该研究纳入了53例患者的57个膝关节（平均年龄27.6岁[范围6 - 65岁]）。平均随访时间为12.1年（范围5.0 - 23.1年）。儿童组有31个膝关节，成人组有26个膝关节。两组之间以及股骨胫骨角的术前和随访值之间均未发现显著差异（P >.05）。比较术前和随访的Kellgren-Lawrence分级时，儿童组未观察到变化（P =.125），而成人组分级显示有进展（P <.001）。儿童组和成人组的平均Lysholm评分分别为94.61±7.61和84.23±14.90（P =.001）。总体而言，2例患者因症状复发接受了关节镜手术，2例患者因骨关节炎接受了关节置换术。10年生存率为90.6%。
DLM的有限盘状成形术有助于保持膝关节冠状面的对线。儿童患者的功能和放射学结果更佳。即使老年患者的对线更内翻，术前和随访的股骨胫骨角在统计学上也无显著差异。这一结果可用于指导适当选择病例的治疗。
