Examination of refractory discoid lateral meniscus injury

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110220
Author(s):  
Fumiyoshi Kawashima ◽  
Hiroshi Takagi
Keyword(s):  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Lysholm Score ◽  
The Body ◽  
Suture Repair ◽  
Discoid Lateral Meniscus ◽  
Short Term ◽  
Shift Type ◽  
The Mean

Background: Lateral discoid meniscus (LDM) should be treated and preserved with saucerization and/or suture repair. However, repair of the meniscal hoop structure is sometimes difficult due to displacement or large defects. In this study, we aimed to examine tear patterns based on the Ahn classification in those requiring meniscal repair and those undergoing subtotal meniscectomy. Methods: Twenty-three patients were evaluated (mean age, 27.4 years; mean follow-up period, 2.5 years). The following were evaluated: displacement morphology based on the Ahn classification, site of tear under arthroscopy, morphology, surgical procedure, Lysholm score at final postoperative follow-up, and clinical outcome of meniscus using Barrett’s criteria. Result: There were 16 knees without displacement (saucerization with suture repair, 13 knees; subtotal meniscectomy, 3 knees) and 10 knees with displacement (reduction with suture repair, 3 knees; subtotal meniscectomy, 7 knees). Subtotal meniscectomy was performed more often in cases with dislocation, especially in the central shift type as defined by the Ahn classification. The mean Lysholm score was 65.0 points preoperatively and 95.3 points postoperatively. Twenty-three knees (88%) were postoperatively categorized under the Barrett’s criteria as healing and 3 knees (12%) were categorized as non-healing. The number of non-healing cases that underwent subtotal meniscectomy was relatively small (1 of 10 knees), and the short-term results were not poor. Conclusion: Localized peripheral longitudinal tears tended to be repairable even with displacement, while peripheral tears covering the entire meniscus or with severe defects/tears in the body of the meniscus tended to be difficult to repair, leading to subtotal meniscectomy.

scholarly journals Revision Meniscal Repair - Failure rates, clinical outcome and patient satisfaction

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0022
Author(s):  
Andreas Fuchs ◽  
Ferdinand Kloos ◽  
Gerrit Bode ◽  
Kaywan Izadpanah ◽  
Norbert Südkamp ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Revision Surgery ◽  
Meniscal Repair ◽  
Sports Participation ◽  
Lysholm Score ◽  
Failure Rates ◽  
The Mean ◽  
High Level

Aims and Objectives: Failure of isolated primary meniscal repair must be expected in 14% - 28%. Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of revision meniscal repair remain unclear. The purpose of this study was therefore to evaluate the clinical outcome and failure rates of revision meniscal repair in patients with re-tears or failed healing after previous isolated meniscal repair in stable knee joints. Materials and Methods: A chart review was performed to identify all patients undergoing revision meniscal repair between 08/2010 and 02/2016. Only patients without concomitant procedures, without ligamentous insufficiency, and a minimum follow-up of 24 months were included. The records of all patients were reviewed to collect patient demographics, injury patterns of the meniscus, and details about primary and revision surgery. Follow-up evaluation included failure rates, clinical outcome scores (Lysholm Score, KOOS Score), sporting activity (Tegner scale), and patient satisfaction. Results: A total of 12 patients with a mean age of 22 ± 5 years were included. The mean time between primary repair and revision repair was 27 ± 21 months. Reasons for failed primary repairs were traumatic re-tears in 10 patients (83%) and failed healing in two patients (17%). The mean follow-up period after revision meniscal repair was 43 months. Failure of revision meniscal repair occurred in 3 patients (25%). In two of these patients, re-revision repair was performed. At final follow-up, the mean Lysholm Score was 95.2 with a range of 90-100, representing a good to excellent result in all patients. The final assessment of the KOOS subscores also showed good to excellent results. The mean Tegner scale was 6.8 ± 1.8, indicating a relatively high level of sports participation. Ten patients (83%) were either very satisfied or satisfied with the outcome. Conclusion: In patients with re-tears or failed healing after previous isolated meniscal repair, revision meniscal repair results in good to excellent knee function, high level of sports participation, and high patient satisfaction. The failure rate is comparable to isolated meniscal repair. Therefore, revision meniscal repair is worthwhile in order to save as much meniscal tissue as possible.

scholarly journals Prospective Short-term MRI controlled investigation of the healing properties of the Meniscus

2017 ◽  
Vol 5 (4_suppl4) ◽  
pp. 2325967117S0014
Author(s):  
Lukas Willinger ◽  
Felix Förschner ◽  
Andreas Imhoff ◽  
Elmar Herbst
Keyword(s):  
Classification System ◽  
Statistical Significance ◽  
Lateral Meniscus ◽  
Meniscus Repair ◽  
Lysholm Score ◽  
Joint Fluid ◽  
Short Term ◽  
Meniscus Tears ◽  
Meniscus Healing

Aims and Objectives: The purpose of the study was to prospectively investigate signal alterations in short-term follow-up after acute meniscus repair on specific magnetic resonance imaging (MRI) scan sequences. It was hypothesized that 1) there are different meniscus healing properties depending on lesion configuration and size, and 2) the tear zone has an influence on the healing properties of the meniscus. Materials and Methods: We conducted this prospective short-term clinical and radiological study to investigate the healing properties of acute meniscus tears. Inclusion criteria were patients (age 18-45 years) with traumatic meniscus lesion, subsequent arthroscopic meniscus repair within 6 weeks and preoperative MRI. Exclusion criteria were age < 18 or >45 years, arthrosis > grade III and multiligamentous knee injuries. Clinical examination and outcome scores (IKDC, KOOS, Lysholm Score) were surveyed preoperatively and 12 weeks after surgery. Meniscus tears were classified according to the ISAKOS meniscus classification system on MRI scans. Radiological assessment using a 3T-MRI was performed preoperatively and 2, 4, 6 and 12 weeks after operation. Meniscus healing were classified according to Henning’s criteria in A) healed, B) partially healed (> 50%) and C) not healed. Data were analyzed using SPSS statistics software version 21 (IBM, New York, USA). Statistical significance was set at a p value of < 0.05. Results: These are preliminary results of 14 patients (13 m, 1w) with a total of 16 meniscus tears. According to the ISAKOS meniscus classification system 9 medial and 7 lateral meniscus tears were included and average tear length was 21.5 mm (6 - 40 mm). 12 tears were located in the rim zone 1 and 4 tears were more medially in zone 2. In 8 (57%) patients an additional anterior cruciate ligament (ACL) reconstruction was performed. Six weeks postoperatively 8 menisci (50%) were deemed healed, 6 menisci (37%) partially healed whereas 2 menisci were not healed (13%). After 12 weeks 9 menisci (56%) were considered healed, 4 menisci (25%) partially healed and 3 menisci (19%) showed intrameniscal joint fluid in more than 50% of meniscus thickness. Two bucket handle tears of the medial meniscus and one radial tear of the lateral meniscus, all located in the red-red zone sized 35 mm, 25 mm and 12 mm, were not healed after 12 weeks. Clinical scores improved significantly 12 weeks after surgery: IKDC Score (preOP: 46.7, postOP: 67.8), KOOS (preOP: 49.7, postOP: 79.1) and Lysholm Score (preOP: 49.5, postOP: 77.7) (p < 0.05). Conclusion: Clinical and radiological follow-up showed good short-term results after meniscus repair. MRI revealed signal alteration in all menisci after 12 weeks, in most instances considered as scar tissue without intrameniscal joint fluid. In this cohohrt tear size and location was not correlated with non-healing. Arthroscopic meniscus repair achieves a high healing response of the meniscus and good clinical outcomes.

scholarly journals A Surgical Algorithm According to Pivot-Shift Grade in Patients With ACL Injury: A Prospective Clinical and Radiological Evaluation

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110254
Author(s):  
Ramazan Akmese ◽  
Sancar Alp Ovali ◽  
Mehmet Mesut Celebi ◽  
Batu Malatyali ◽  
Hakan Kocaoglu
Keyword(s):  
Pivot Shift ◽  
Root Function ◽  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Anterolateral Ligament ◽  
Rotational Instability ◽  
Meniscus Root ◽  
The Mean ◽  
Grade 3

Background: Some patients have a positive pivot-shift finding and rotational instability after anterior cruciate ligament (ACL) reconstruction (ACLR). Three major pathologies known to affect the pivot-shift examination include ACL tear, anterolateral ligament injury, and loss of posterior lateral meniscus root function. Purpose: To describe a surgical algorithm determining indications for lateral extra-articular tenodesis (LET) based on intraoperative pivot-shift examination to prevent postoperative pivot shift and rotational instability and to evaluate the 2-year clinical and functional outcomes. Study Design: Case series; Level of evidence, 4. Methods: The study included 47 consecutive patients (39 men and 8 women) who underwent operative treatment for ACL injury between 2016 and 2017. Pivot-shift examination was performed under anesthesia, and the pivot shift was graded as grade 1 (glide), grade 2 (clunk), or grade 3 (gross). According to the surgical algorithm, single-bundle ACLR was performed in patients with grade 1 pivot shift. In patients with grade 2 with loss of posterior lateral meniscus root function, concurrent lateral meniscal repair was performed, and in patients with grade 2 with an intact lateral meniscus posterior root, concurrent extra-articular iliotibial band tenodesis was performed. Patients with grade 3 underwent ACLR, lateral meniscal repair, and LET. Clinical and radiographic evaluations were performed. Results: The mean age was 27.2 years (range, 16-56 years). In total, 26 (55.3%) patients were evaluated as having pivot-shift grade 1; 16 (34%) patients, grade 2; and 5 (10.6%) patients, grade 3. A total of 7 (14.9%) patients underwent LET in addition to ACLR. Two of these patients had pivot-shift grade 2, and LET was performed since the lateral meniscus posterior root was intact. In 14 of 16 patients with grade 2, lateral meniscus root disruption was detected, and lateral meniscal repair was performed. One patient was excluded from the further follow-up because of graft failure. At a mean postoperative follow-up of 29 months in 46 patients, the pivot-shift examination was negative in all patients. The mean Lysholm and International Knee Documentation Committee subjective scores were 95.35 ± 4.40 and 82.87 ± 9.36, respectively. Radiographic evidence of osteoarthritis was not detected. Conclusion: Only 14.9% of patients needed LET. With proper ACL, lateral meniscal, and anterolateral ligament surgery, it was possible to prevent positive pivot-shift findings postoperatively.

scholarly journals Clinical Outcomes of Revision Meniscal Repair

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0046
Author(s):  
Muhammad Sakti
Keyword(s):  
Revision Surgery ◽  
Primary Repair ◽  
Meniscal Repair ◽  
Lysholm Score ◽  
Patient Demographics ◽  
Outcome Scores ◽  
The Mean ◽  
Location Type ◽  
Record Review

Background: The failure rate after arthroscopic primary meniscal repair ranges from 5% to 43.5% (mean 15%). Patients requiring revision surgery may benefit from revision meniscal repair, however, the results of this procedure remain underreported. Objective: This was a retrospective study aim to evaluate the outcome of revision meniscal repair in patients with re-tears in Makassar’s hospitals from 2010 – 2017. Methods: A medical record review was performed to identify all patients undergoing revision meniscal repair between 2010 and 2017 in Makassar’s hospitals. Only patients with re-tears of the primary repaired meniscus were included. Surgical technique of primary and revision meniscus repair was detailed. The records of all patients were reviewed to collect patient demographics, affected side of the re-teared meniscus, reasons for failed primary repair, combined disorder, location of the tear, and duration between the primary and revision surgery. Follow-up evaluation included clinical outcome scores (Lysholm Score). Results: A total 9 of 15 patients (5 male and 4 female) with a mean age of 25.3 years (range, 19 to 44) and a mean BMI of 24.48 kg/m2 (range, 19.6 to 32.9) were included. Three lateral menisci and six medial meniscal repairs were revised at mean 23.3 months (range, 19 to 32) after primary repair. Reasons for failed primary repairs were traumatic re-tears in 4 patients (44%) and non-traumatic re-tears in 5 patients (56%). Patients undergoing isolated meniscal repair were found in 6 patients, 2 patients with ACL concomitant disorder, and 1 patient with osteoarthritis. Two tears occurred in the red-red zone and 7 in the red-white zone. At final follow-up, the mean Lysholm score significantly improved from 79.8 points (range, 75-84 points) at pre-revision to 88.1 (range, 80 to 97). Conclusion: Meniscal repair should always be considered when the anatomic conditions are favorable (location, type of tear, ACL status).

scholarly journals Arthroscopic Xenograft Repair of Massive, Irreparable Rotator Cuff Tears

1970 ◽  
Vol 14 (2) ◽  
pp. 214-221 ◽  
Author(s):  
In Bo Kim ◽  
Dong Jun Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Tendon Healing ◽  
The Body ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
Short Term ◽  
The Mean

PURPOSE: Our purpose was to assess the short-term results of arthroscopic bridging repair of massive, irreparable rotator cuff tears by use of a Permacol(R).MATERIALS AND METHODS: Between October 2010 and April 2011, 6 patients with massive, irreparable rotator cuff tears were treated with arthroscopic bridging repair using a Permacol(R). All were evaluated preoperatively and postoperatively by use of the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging was performed postoperatively at mean 4.2 months (range, 2 to 10 months) after operation.RESULTS: At a mean follow-up of 7 months (range, 4 to 12 months), the mean KSS increased significantly from preoperatively mean 53.0 to postoperatively mean 72.3 (p=0.046). Statistically insignificant improvements were seen in pain (p=0.066) and range of motion (p=0.336). As documented on magnetic resonance imaging, there were two patients with full incorporation of the graft into the native tissue, 1 partial retear, and 3 complete retear. There were no complications such as adverse inflammatory or septic joint in these patients.CONCLUSION: Although Permacol(R), porcine dermal xenograft may be effective in other areas of the body for tendon healing, its use in bridging repair of massive, irreparable rotator cuff tears seems to have to be chosen prudently and warrants further evaluation.

A Novel Magnetic Resonance Imaging Classification of Discoid Lateral Meniscus Based on Peripheral Attachment

2009 ◽  
Vol 37 (8) ◽  
pp. 1564-1569 ◽  
Author(s):  
Jin Hwan Ahn ◽  
Yong Seuk Lee ◽  
Hae Chan Ha ◽  
Jong Sup Shim ◽  
Kyung Sub Lim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lateral Meniscus ◽  
Discoid Lateral Meniscus ◽  
Resonance Imaging ◽  
Chi Square ◽  
Shift Type ◽  
Chi Square Test ◽  
Imaging Classification

Background In the symptomatic discoid lateral meniscus, the effectiveness of preoperative magnetic resonance imaging (MRI) is not well documented. Hypothesis Magnetic resonance imaging classification will provide more information to the surgeon in choosing the appropriate treatment methods with the help of arthroscopic findings. Study design Cohort study (diagnosis); Level of evidence, 2. Methods Sixty-seven patients (82 knees) were reviewed. The preoperative MRI was checked in 76 of 82 knees. The Lysholm and Ikeuchi grading scales were evaluated. Images were analyzed from MRI, and findings were classified into 4 categories: no shift, anterocentral shift, posterocentral shift, and central shift. Tear pattern classifications were based on arthroscopic findings: horizontal tear, peripheral tear, horizontal and peripheral tear, posterolateral corner loss, and others. The correlations between MRI classification tear patterns and surgical methods were analyzed using the chi-square test or the Fisher exact test. The sensitivity, specificity, and accuracy of shift in preoperative MRI–according to the existence of peripheral tear when corroborated with arthroscopy–were also analyzed with the chi-square test. Inter- and intraobserver reliability was statistically analyzed by producing the inter- and intraclass correlation coefficient. Results The mean preoperative Lysholm score was 77.3 (range, 43-97), and the last follow-up Lysholm score had increased to 96.8 (range, 84-100; P <. 001). At last follow-up (100% follow-up), the Ikeuchi grading scale scored 48 knees as excellent, 30 as good, and 4 as fair. According to the MRI classification, 43 knees were no shift; 6, anterocentral shift; 15, posterocentral shift; and 12, central shift. Shift-type knees had a significantly larger number of peripheral tears, and repairs were performed in the shift-type knees (55%) more frequently than in the no-shift-type knees (28%). Among 82 knees, 31 were repaired simultaneously after a central partial meniscectomy. Conclusion Magnetic resonance imaging classification provides more information to surgeons in choosing the appropriate treatment methods, although the final decision regarding procedure is made during arthroscopy after thorough analysis of the tear.

scholarly journals Discoid lateral meniscus: importance, diagnosis, and treatment

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Jun-Ho Kim ◽  
Jin Hwan Ahn ◽  
Joo-Hwan Kim ◽  
Joon Ho Wang
Keyword(s):  
Lateral Meniscus ◽  
Meniscal Repair ◽  
Asian Population ◽  
Partial Meniscectomy ◽  
Diagnosis And Treatment ◽  
Discoid Lateral Meniscus ◽  
Asymptomatic Patients ◽  
Increased Risk ◽  
Long Term Follow Up

Abstract Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. Snapping and pain are common symptoms, with occasional limitations of extension, in patients with DLM. Examination of the contralateral knee is necessary as DLM affects both knees. While simple radiographs may provide indirect signs of a DLM, magnetic resonance imaging (MRI) is essential for diagnosis and treatment planning. Although DLM was traditionally classified into three categories, namely, complete, incomplete, and Wrisberg DLM, a recent MRI classification provides useful information for surgical planning because the MRI classification was based on the peripheral detachment in patients with DLM, as follows: no shift, anterocentral shift, posterocentral shift, and central shift. Asymptomatic patients require close follow-up without surgical treatment, while patients with symptoms often require surgery. Total or subtotal meniscectomy, which has been traditionally performed, leads to an increased risk of degenerative arthritis; thus, partial meniscectomy is currently considered the treatment of choice for DLM. In addition to partial meniscectomy, meniscal repair of peripheral detachment is recommended for stabilization in patients with DLM to preserve the function of the meniscus. Previous studies have reported that partial meniscectomy with or without meniscal repair is effective and shows superior clinical and radiological outcomes to those of total or subtotal meniscectomy during the short- to long-term follow-up. Our preferred principle for DLM treatment is reduction, followed by reshaping with reference to the midbody of the medial meniscus and repair as firm as possible.

scholarly journals How Consistent are the MRI Findings and the Clinical Outcomes after Meniscus Repair?

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0013
Author(s):  
Hasan Bombaci ◽  
Fatih Cetinkaya ◽  
Kaan Meric
Keyword(s):  
Clinical Outcomes ◽  
Meniscal Repair ◽  
Meniscus Repair ◽  
Lysholm Score ◽  
Activity Score ◽  
Meniscus Tear ◽  
Mri Findings ◽  
Mri Examination ◽  
The Mean

Objectives: The meniscal repair is a preferred treatment whenever possible after meniscus tear. There are reports in the literature that MRI assessment is not useful to evaluate healing of the meniscus after repair. However, we have not found any study which compares the clinical outcomes of meniscus repair according to the MRI findings. The purpose of this study was to compare the MRI features and the clinical outcomes after meniscus repair. Methods: 32 patients underwent meniscus repair between January 2011 and June 2013. Twenty three of them accepted a control MRI examination at last follow-up visit. One patient was more than 130 kg in weight so it was not possible to perform MRI examination in our institution. Therefore, twenty-two patients (17 male, 5 female) were included in this study. The mean age was 31.81 (18-48). Preoperative clinical and radiological findings were obtained from the hospital registry. At last follow-up, the clinical examination and MRI assessment were performed. The results were compared statistically with the ANOVA method. Results: MRI assessment, obtained at the last follow-up, was performed blindly by the radiology specialist and senior surgeon and any conflicts between the two assessments were settled by using the preoperative MRI findings. In 10 patients (45.45%), the MRI examination revealed normal/nearly normal meniscal signal alteration, in three (13.64%), incomplete tear and in nine (40.91%), a vertical/complex tear signal located in the previously torn meniscus area. Post-operatively the mean Lysholm score was 91.40±10.57 and Tegner activity score, 4.59±1.62. Also, the Lysholm score (91.5±12.44, 94.33±5.50 and 90.33±10.34, respectively) and Tegner activity score (4.2±1.87, 6±1.00 and 4.5±1.33, respectively) were evaluated in each group separately, however the difference was not statistically significant (p>0.05). Conclusion: In the present study, there was no correlation between the MRI signals and clinical outcomes. The Lysholm score was found to be over 90 in 20 of the 22 knees in this series. In conclusion, the findings reveal that the meniscus fulfills its function as normal or nearly normal even though the MRI findings fail to prove healing, in the mean 19. 5 months’ period postoperatively.

scholarly journals Autologous Matrix-Induced Chondrogenesis for Treatment of Focal Cartilage Defects in the Knee: A Follow-up Study

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098187
Author(s):  
Justus Gille ◽  
Ellen Reiss ◽  
Moritz Freitag ◽  
Jan Schagemann ◽  
Matthias Steinwachs ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Demographic Data ◽  
Case Series ◽  
Defect Size ◽  
Lysholm Score ◽  
Outcome Analysis ◽  
Cartilage Defects ◽  
Chondral Defects ◽  
The Mean

Background: Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects. Purpose: To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee. Study Design: Case series; Level of evidence, 4. Methods: A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm2. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points. Results: The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( P < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes. Conclusion: AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.

Open-wedge high tibial osteotomy in patients with discoid lateral meniscus

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110173
Author(s):  
Hee-June Kim ◽  
Ji-Yeon Shin ◽  
Hyun-Joo Lee ◽  
Chul-Hee Jung ◽  
Kyeong-Hyeon Park ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Lateral Meniscus ◽  
Lateral Compartment ◽  
Clinical Results ◽  
Discoid Lateral Meniscus ◽  
Tibial Osteotomy ◽  
Open Wedge ◽  
Factors Affecting ◽  
The Mean ◽  
Open Wedge Hto

Background: There are concerns about the progression of the lateral osteoarthritis (OA) should be taken into account when high tibial osteotomy (HTO) is performed in patients with discoid lateral meniscus (LM). This study evaluated the clinical results of HTO in patients with discoid LM and elucidated factors affecting the results. Methods: This study evaluated 32 female patients with varus deformity and medial OA. Patients with discoid LM (8 patients) or without discoid LM (24 patients) underwent open-wedge HTO. The mean age was 53.5 years and the mean follow-up period was 35 months. Clinical results, including the Hospital for Special Surgery (HSS) score, Knee Society knee score (KS) and function score (FS), were evaluated. The progression of OA in the lateral compartment was also evaluated. Finally, we evaluated the factors affecting the clinical results and OA progression in the lateral compartment. Results: Between two groups, all clinical scores were not different (p = 0.964, 0.963, and 0.559, respectively). Three of eight patients (37.5%) in the discoid group developed OA in the lateral compartment, whereas 2 of 24 patients (8.3%) in the control group developed such; however, this was not significantly different (p = 0.085). In discoid group, patients with undercorrection has higher KS relative to patients with acceptable correction (p = 0.044). Other clinical results and OA change in the lateral compartment were not affected by evaluated factors. Conclusions: Patients who underwent open-wedge HTO showed the satisfactory clinical results and lateral OA progression regardless of the presence or absence discoid LM. However, when discoid LM was present, patients with undercorrection showed higher KS in comparison with patients with acceptable correction.

Sign in / Sign up

Export Citation Format

Share Document