Abstract
BackgroundDue to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; however, postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM.MethodsPatients with DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were enrolled according to the inclusion and exclusion criteria. Fourteen variables, including sex, body mass index (BMI) and other variables, were chosen as factors for study. Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Univariate analyses (Mann-Whitney U test or Kruskall-Wallis rank sum test) and multivariate analyses (ordinal logistic regression) were used to identify the factors that influenced postoperative outcomes. P < 0.05 was considered statistically significant.ResultsA total of 502 patients, including 353 females (70.3%) and 149 males (29.7%), were enrolled. The median IKDC score postoperatively (87.4; range, 41.4 ~ 97.7; IQR, 14.6) was higher than that preoperatively (57.6; range, 26.9 ~ 64.9; IQR, 9.7) (P < 0.001). Male sex was predictive of a higher IKDC score (P = 0.023, OR = 1.702). Compared with BMI ≥25 kg/m2, < 18.5 kg/m2 was associated with better IKDC score (P = 0.026, OR = 3.016). Contrasting with age of onset ≥45 years, ≤14 years (P < 0.001, OR = 20.780) and 14 ~ 25 years (P < 0.001, OR = 8.516) were associated with better IKDC score. In comparison with symptoms duration> 24 months, IKDC scores for patients with symptoms duration ≤1 month (P = 0.001, OR = 3.511), 1 ~ 6 months (P < 0.001, OR = 3.463) and 6 ~ 24 months (P < 0.001, OR = 3.254) were significantly elevated. Compared to Outerbridge grade III ~ IV, no injury (P < 0.001, OR = 6.379) and grade I (P = 0.01, OR = 4.332) were associated with higher IKDC score.ConclusionsArthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5 kg/m2, age of onset < 25 years (especially < 14 years) and symptoms duration < 24 months are conducive to good postoperative outcomes. However, combined articular cartilage injury (Outbridge grade ≥ 2) reduces postoperative effect.
Highlights
Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms
Compared with body mass index (BMI) ≥ 25 kg/m2, BMI < 18.5 kg/m2 was associated with better International Knee Documentation Committee (IKDC) score (P = 0.026, Odds ratio (OR) = 3.016, 95% Confidence interval (CI): 1.138–7.996), while no difference was found between 18.5 kg/m2 ≤ BMI < 25 kg/m2 and BMI ≥ 25 kg/m2 regarding IKDC score (P = 0.063, OR = 1.701, 95% CI: 0.972–2.974)
Through investigating 502 patients with DLM, we found that male sex was a protective factor for good knee function (P = 0.023, OR = 1.702, 95% CI: 1.076– 2.697)
Summary
Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM. In the ultrastructure of the discoid meniscus, the radial and circular collagen fibre systems are reduced and disorganized, and the circular collagen fibres are insufficient in strength and show increased brittleness. These morphological and histological abnormalities make the discoid meniscus liable to tearing and degeneration [1,2,3]. Patients suffering from bilateral DLM accounts for 79–97% of cases [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
