A Torn Discoid Lateral Meniscus Impacts Lower-Limb Alignment Regardless of Age: Surgical Treatment May Not Be Appropriate for an Asymptomatic Discoid Lateral Meniscus.

Abstract

A discoid lateral meniscus (DLM) is more prone to tear, and treatment of this condition is challenging. The purpose of the present study was to investigate (1) whether a torn DLM is associated with more varus alignment than a torn semilunar lateral meniscus (SLM) and (2) whether the lower-limb alignment associated with a torn DLM changes with age. Consecutive patients who underwent arthroscopic knee surgery for a torn lateral meniscus were included. Patients with a torn DLM (confirmed on arthroscopy) were allocated to the DLM group; those with a torn SLM were allocated to the SLM group. After strict screening according to the inclusion and exclusion criteria, 436 and 423 patients were included in the DLM and SLM groups, respectively. The mechanical axis deviation (MAD), hip-knee-ankle angle (HKA), mechanical lateral distal femoral angle, and medial proximal tibial angle were compared between the 2 groups after propensity score matching. Additionally, the correlation of the HKA and MAD with age was evaluated within the DLM group. After propensity score matching, all baseline characteristics were well balanced between the 2 groups. The DLM group had significantly more varus alignment than the SLM group (MAD: 3.6 mm ± 9.6 mm versus 1.1 mm ± 10.3 mm, respectively, p = 0.001; HKA: 179.1° ± 2.9° versus 179.9° ± 3.0°, respectively, p = 0.001). Within the DLM group, the MAD (R = 0.10, p = 0.032) and HKA (R = -0.13, p = 0.007) had a weak correlation with age. Patients with a torn DLM had more varus knee alignment than those with a torn SLM, and this trend did not increase with age after minimizing the effects of osteoarthritis. Therefore, surgical treatment may not be appropriate for asymptomatic DLM. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.