Posterior subtotal meniscectomy revealed the worst scenario for the progression of osteocartilaginous damage in cases of juvenile discoid lateral meniscus with peripheral tear,Archives of Orthopaedic and Trauma Surgery

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Posterior subtotal meniscectomy revealed the worst scenario for the progression of osteocartilaginous damage in cases of juvenile discoid lateral meniscus with peripheral tear
Archives of Orthopaedic and Trauma Surgery ( IF 2.0 ) Pub Date : 2023-01-03 , DOI: 10.1007/s00402-022-04747-0
Yusuke Hashimoto ₁ , Kazuya Nishino ₁ , Shinya Yamasaki ₂ , Yohei Nishida ₃ , Tomohiro Tomihara ₄ , Hiroaki Nakamura ₁

Affiliation

Introduction

We compared subtotal meniscectomy and saucerization with stabilization for osteocartilaginous damage based on injured location and further examined the factors related to osteocartilaginous damage in juvenile discoid lateral meniscus (DLM) with peripheral tear after a follow-up period of at least 5 years.

Materials and methods

We retrospectively reviewed juvenile DLM patients with peripheral tear who underwent arthroscopic surgery with more than 5 years of follow-up. Osteocartilaginous damage, which was identified by osteochondritis dissecans (OCD) development and the whole-organ magnetic resonance imaging score (WORMS) of cartilage grade ≥ 3, was compared between subtotal meniscectomy and saucerization with stabilization. A subgroup analysis examining the location of the tear site was performed. Factors for osteocartilaginous damage were analyzed between the damaged and non-damaged groups.

Results

Forty-one patients, including 29 who underwent saucerization with stabilization and 12 who underwent subtotal meniscectomy, were included in this study. Seven patients developed OCD lesions; six patients showed cartilage WORMS of more than grade 3. Overall, there was a significant difference in the total cartilage and meniscus WORMS between the two groups at the final follow-up. The subgroup analysis demonstrated more severe osteocartilaginous damage developed in posterior subtotal meniscectomy than in posterior stabilization following saucerization. The damaged group showed significant difference compared to the non-damaged group in terms of age (p = 0.003), sex (p = 0.036), and posterior subtotal meniscectomy (p < 0.001).

Conclusions

Posterior subtotal meniscectomy revealed the worst scenario for the progression of osteocartilaginous damage in cases of juvenile DLM with peripheral tear over a minimum follow-up period of 5 years.

中文翻译：

后半月板次全切除术揭示了幼年盘状外侧半月板周边撕裂病例中骨软骨损伤进展的最坏情况

介绍

我们根据受伤部位比较了半月板次全切除术和碟化术与稳定术对骨软骨损伤的影响，并在至少 5 年的随访后进一步研究了与周围撕裂的幼年盘状外侧半月板 (DLM) 骨软骨损伤相关的因素。

材料和方法

我们回顾性分析了接受关节镜手术并随访超过 5 年的患有外周撕裂的青少年 DLM 患者。通过剥脱性骨软骨炎 (OCD) 发展和软骨等级≥ 3 级的全器官磁共振成像评分 (WORMS) 来确定骨软骨损伤，比较半月板次全切除术和稳定碟形术之间的关系。进行了检查撕裂部位位置的亚组分析。分析受损组和未受损组之间骨软骨损伤的因素。

结果

本研究纳入了 41 名患者，其中 29 名患者接受稳定碟形术，12 名患者接受半月板次全切除术。七名患者出现强迫症病变；6名患者出现3级以上的软骨WORMS。总体而言，最终随访时两组之间的总软骨和半月板WORMS存在显着差异。亚组分析表明，后半月板次全切除术中发生的骨软骨损伤比碟化后后稳定中更严重。受损组与未受损组在年龄 ( p = 0.003)、性别 ( p = 0.036) 和后半月板次全切除术 ( p < 0.001) 方面显示出显着差异。