The postoperative shorter meniscal width was the risk factor of lateral meniscal extrusion in the middle portion for juv
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The postoperative shorter meniscal width was the risk factor of lateral meniscal extrusion in the middle portion for juvenile and adolescent knees with discoid lateral meniscus Tomoharu Mochizuki1 · Osamu Tanifuji1 · Satoshi Watanabe2 · Takashi Sato2 · Naoto Endo1 Received: 25 March 2020 / Accepted: 24 July 2020 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020
Abstract Purpose The study aim was to clarify the risk factors for postoperative meniscal extrusion in a middle portion in juvenile and adolescent knees with DLM. Methods Forty-six patients with symptomatic DLM who underwent surgery were retrospectively assessed. Inclusion criteria were set as follows: (1) aged ≤ 17 years with an open growth plate, (2) preoperative and postoperative follow-up MRI, and 3) reshaping surgeries comprising of saucerization alone or with meniscal repair. Average (95%CI) age during surgery, body mass index (BMI), and follow-up duration were 12 years (11–13), 19.9 kg/m2 (18.7–21.0), and 26.4 months (19.5–33.3), respectively. Age, sex, sports activities, BMI, postoperative rehabilitation, preoperative shift of DLM by Ahn’s classification, surgical procedures, postoperative meniscal width of all portions, and meniscal healing were analyzed. Results Postoperatively, eight knees in the no-extrusion group and 38 knees in the extrusion group were observed. In the univariate logistic regression analysis, shorter meniscal width in a middle portion (OR = 1.580, p = 0.006), shorter minimum width of all portions (OR = 1.674, p = 0.024), and meniscal healing (OR = 0.160, p = 0.028) were the risk factors for meniscal extrusion in a middle portion. Multiple logistic regression analysis demonstrated that shorter meniscal width in a middle portion was the risk factor. Conclusions As the clinical relevance, to prevent postoperative meniscal extrusion of the middle portion with DLM, surgeons are necessary to pay attention to maintain the adequate meniscal width for juvenile and adolescent knees. Level of evidence III Keywords Discoid lateral meniscus · Postoperative meniscal extrusion · Juvenile and adolescent knees · Meniscal width
Introduction * Tomoharu Mochizuki [email protected] Osamu Tanifuji [email protected] Satoshi Watanabe [email protected] Takashi Sato [email protected] Naoto Endo [email protected]‑u.ac.jp 1
Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1‑757 Asahimachi‑dori Chuo‑ku, Niigata, Niigata 951‑8510, Japan
Department of Orthopaedic Surgery, Niigata Medical Center, 3‑27‑11, Kobari, Nishi‑ku, Niigata 950‑2022, Japan
2
Arthroscopic meniscal saucerization with meniscal repair is considered as the gold-standard treatment in discoid lateral meniscus (DLM) [2, 5, 21]. Nevertheless, the repair process cannot completely prevent osteochondral dissecans (OCD) and osteoarthritic changes in juvenile and adolescent knees [2, 19]. These adverse events are at
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