scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2020 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Clinical Symptoms ◽  
Age Of Onset ◽  
Arthroscopic Surgery ◽  
Lateral Meniscus ◽  
International Knee Documentation Committee ◽  
Influential Factors ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Ikdc Score ◽  
Male Sex

Abstract Background: 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; 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. Methods: Patients 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.Results: A 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.Conclusions: Arthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5kg/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.

scholarly journals Multivariate ordered logistic regression analysis of the postoperative effect of symptomatic discoid lateral meniscus

2021 ◽  
Author(s):  
Shun-Jie Yang ◽  
Jian Li ◽  
Yang Xue ◽  
Zhong Zhang ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Age Of Onset ◽  
Univariate Analysis ◽  
Arthroscopic Surgery ◽  
Lateral Meniscus ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Duration Of Symptoms ◽  
Ordered Logistic Regression

Abstract Introduction The postoperative effect of arthroscopy in the treatment of symptomatic discoid lateral meniscus (DLM) varies greatly among individuals. Therefore, this study aims to investigate the factors affecting the postoperative outcomes of symptomatic DLM. Materials and methods According to the inclusion and exclusion criteria, patients with symptomatic single-knee DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were included. Retrospectively collected 16 factors probably affecting postoperative outcomes. The Ikeuchi grade system was used to evaluate the knee joint function. Univariate analysis was performed by Kruskal–Wallis rank-sum test or Mann–Whitney U test, and multivariate analysis by ordered logistic regression. P < 0.05 was considered statistically significant. Results A sum of 502 patients was included, including 353 females (70.3%) and 149 males (29.7%). Difference between preoperative and postoperative Ikeuchi grade was statistically significant (P < 0.001). Female was bad to obtain a good Ikeuchi grade (P = 0.009, OR 0.458). Outerbridge grade (P = 0.018, OR 0.638) was negatively correlated with Ikeuchi grade. BMI (P = 0.001, OR 0.875) and work intensity (P = 0.020, OR 0.611) were inversely correlated with Ikeuchi grade. Age of onset (P < 0.001, OR 0.956) and symptoms duration (P < 0.001, OR 0.988) were negatively correlated with Ikeuchi grade. Besides, compared to total meniscectomy, meniscoplasty with a repair was an unfavourable factor for Ikeuchi grade (P = 0.044, OR 0.245). Conclusions With the increase of BMI, work intensity, age of onset, duration of symptoms, and the severity of cartilage lesion, the postoperative results become worse. Moreover, female and meniscoplasty with repair are risk factors for the postoperative outcomes.

scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2020 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Age Of Onset ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Discoid Meniscus ◽  
Cartilage Lesions ◽  
Outerbridge Grade

Abstract Background: Discoid lateral meniscus (DLM) have a higher rate of tear and degeneration for its abnormal shape and structure. Arthroscopy is the main treatment for symptomatic DLM, however, postoperative clinical outcomes vary widely resulting from effects of diverse factors. Therefore, the present research aims to explore the factors influencing postoperative clinical outcomes of symptomatic DLM . Methods: Patients with discoid meniscus who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were selected according to the inclusion and exclusion criteria. Gender, body mass index (BMI) ,and 18 other factors were selected as potential predictors that might affect postoperative outcomes . Knee function was assessed by the Lysholm, Tegner, International Knee Documentation Committee (IKDC) and Ikeuchi scales. Univariate analyses (rank-sum test and chi-squared test) and multivariate analyses (ordered logistic regression and logistic regression) were used to detect the risk factors bearing on postoperative outcomes. P<0.05 was considered statistically significant. Results: A total of 502 patients were enrolled. Female gender was an influencing factor for Lysholm (P=0.002, odds ratio (OR) =2.713), Tegner (P=0.001, OR=2.526) , IKDC (P=0.022, OR=1.735) and Ikeuchi scores (P=0.010, OR=2.164). BMI was negatively correlated with Lysholm (P=0.007, OR=1.119) and IKDC (P=0.029, OR=1.088) scores. Work intensity was negatively related to IKDC (P=0.038, OR=1.492) and Ikeuchi (P=0.014, OR=1.689) scores. Age of onset was inversely correlated with Tegner (P<0.001, OR=1.109) score.Symptoms duration and IKDC (P=0.002, OR=1.020) had an inverse correlation. Lack of cartilage lesions was a protective factor in terms of Tegner score (P<0.001, OR=0.261). Outerbridge grade was negatively correlated with Lysholm (P=0.016, OR=1.589) and Ikeuchi (P=0.017, OR=1.582) scores. Saucerization with repair was a risk factor for poor Ikeuchi scores (P=0.037, OR=4.328) in terms of subtotal/total meniscectomy. Conclusion: Arthroscopic treatment of symptomatic DLM is safe and effective . Female sex, cartilage lesions and saucerization with repair may be related to unfavourable postoperative outcomes. Clinical efficacy may worsen with increasingBMI, work intensity, symptomatic duration, age of onset and Outerbridge grade.

Discoid Lateral Meniscus

2017 ◽  
Vol 30 (09) ◽  
pp. 854-862 ◽  
Author(s):  
Wen-Li Dai ◽  
Hua Zhang ◽  
Ai-Guo Zhou ◽  
Gang Zhang ◽  
Jian Zhang
Keyword(s):  
Meta Analysis ◽  
Lateral Meniscus ◽  
International Knee Documentation Committee ◽  
Partial Meniscectomy ◽  
Discoid Lateral Meniscus ◽  
Cochrane Database ◽  
Long Term Follow Up ◽  
Dichotomous Outcomes

AbstractPartial and total meniscectomies are the most common treatments for patients with discoid lateral meniscus (DLM). We conducted this study to quantitatively assess and compare the outcomes of partial and total meniscectomies for DLM. We also assessed whether the outcomes differed by the type of DLM, duration of follow-up, and age of patients. We searched PubMed, Embase, and the Cochrane database to identify relevant studies that reported outcomes, including Ikeuchi grade, the International Knee Documentation Committee (IKDC) Subjective Knee score, Lysholm score, or failure rate, in patients who underwent partial and total meniscectomies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for dichotomous outcomes, whereas mean difference and 95% CIs were calculated for continuous outcomes. Fifteen studies met the inclusion criteria. The overall rate of excellent (E) or good (G) postoperatively was 85.5% (95% CI: 79.5–91.5%). The E or G rate of partial meniscectomy was significantly higher than that of total meniscectomy (OR= 1.97, 95% CI: 1.03–3.75, p = 0.038). Besides, patients younger than 20 years had a significantly higher E or G rate than those older than 20 years. (OR = 3.12, 95% CI: 1.18–8.23, p = 0.022). We also found the E or G rate tended to decrease from short- to long-term follow-up. Our systematic review and meta-analysis showed that that partial meniscectomy could achieve better outcomes compared with total meniscectomy for DLM patients.

scholarly journals Factors influencing postoperative outcomes in patients with symptomatic discoid lateral meniscus

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Shun-Jie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Lateral Meniscus ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Factors Influencing

scholarly journals Discoid Lateral Meniscus Incidence During Knee Arthroscopy

2015 ◽  
Vol 16 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Miodrag Glisic ◽  
Zoran Blagojevic ◽  
Branko Ristic ◽  
Vladan Stevanovic ◽  
Aleksandar Matic ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Knee Arthroscopy ◽  
Lateral Meniscus ◽  
Subjective Symptom ◽  
Common Type ◽  
Discoid Lateral Meniscus ◽  
Discoid Meniscus ◽  
Precise Diagnosis ◽  
Ikdc Score ◽  
Distribution Type

Abstract Discoid meniscus is a morphological anomaly of the lateral meniscus that appears in 1–5% of meniscectomies. A precise diagnosis remains difficult to make, and many dilemmas hinder effective treatment. To evaluate the incidence of discoid meniscus in patients who underwent knee arthroscopy, as well as the discoid meniscus type, follow-up problems, combined knee lesions, and postoperative results. This retrospective study included 1357 patients who received knee arthroscopy during the period between January 2007 and December 2013. We analysed the discoid meniscus incidence, sex distribution, type distribution (Monllau classification), noted preoperative symptomatology, rupture incidence and type (O’Connor classification), anomaly presence and other intra-articular lesion correlations. The IKDC score was used to evaluate the operative treatment results. The DLM incidence was 1.03%. The most common type of discoid meniscus was complete 5 (35.71 %). The dominant symptom was pain, which was reported by 12 (85.71%) patients. Eleven (78.57 %) patients exhibited ruptures, and the most common type was horizontal, which was reported in 4 (36.36%) cases. The number of ruptures was significantly higher in patients older than 18 (9 patients; 90%), compared to those younger than 18 (2 patients; 40%). Operative treatment resulted in an improvement for all patients in terms of subjective symptom reduction. The incidence of DLM in our study was 1.03%, and the dominant symptom was pain in the knee (85.71%). The most common lesion of the meniscus was a horizontal split, primarily in patients older than 18 years. Patients also presented with joint intra-articular lesions; the most common type was ACL rupture. In all patients, an improved postoperative IKDC score was reported.

scholarly journals Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

2019 ◽  
Author(s):  
ShunJie Yang ◽  
Zhong-Jun Ding ◽  
Jian Li ◽  
Yang Xue ◽  
Gang Chen
Keyword(s):  
Logistic Regression ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Age Of Onset ◽  
Postoperative Outcomes ◽  
Discoid Lateral Meniscus ◽  
Work Intensity ◽  
Discoid Meniscus ◽  
Cartilage Lesions ◽  
Outerbridge Grade

Abstract Background: Discoid lateral meniscus (DLM) have a higher rate of tear and degeneration for its abnormal shape and structure. Arthroscopy is the main treatment for symptomatic DLM, however, postoperative clinical outcomes vary widely resulting from effects of diverse factors. Therefore, the present research aims to explore the factors influencing postoperative clinical outcomes of symptomatic DLM. Methods: Patients with discoid meniscus who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were selected according to the inclusion and exclusion criteria. Gender, body mass index (BMI), and 18 other factors were selected as potential predictors that might affect postoperative outcomes. Knee function was assessed by the Lysholm, Tegner, International Knee Documentation Committee (IKDC) and Ikeuchi scales. Univariate analyses (rank-sum test and chi-squared test) and multivariate analyses (ordered logistic regression and logistic regression) were used to detect the risk factors bearing on postoperative outcomes. P<0.05 was considered statistically significant.Results: A total of 502 patients were enrolled. Female gender was an influencing factor for Lysholm (P=0.002, odds ratio (OR)=2.713), Tegner (P=0.001, OR=2.526), IKDC (P=0.022, OR=1.735) and Ikeuchi scores (P=0.010, OR=2.164). BMI was negatively correlated with Lysholm (P=0.007, OR=1.119) and IKDC (P=0.029, OR=1.088) scores. Work intensity was negatively related to IKDC (P=0.038, OR=1.492) and Ikeuchi (P=0.014, OR=1.689) scores. Age of onset was inversely correlated with Tegner (P<0.001, OR=1.109) score. Symptoms duration and IKDC (P=0.002, OR=1.020) had an inverse correlation. Lack of cartilage lesions was a protective factor in terms of Tegner score (P<0.001, OR=0.261). Outerbridge grade was negatively correlated with Lysholm (P=0.016, OR=1.589) and Ikeuchi (P=0.017, OR=1.582) scores. Saucerization with repair was a risk factor for poor Ikeuchi scores (P=0.037, OR=4.328) in terms of subtotal/total meniscectomy.Conclusion: Arthroscopic treatment of symptomatic DLM is safe and effective. Female sex, cartilage lesions and saucerization with repair may be related to unfavourable postoperative outcomes. Clinical efficacy may worsen with increasing BMI, work intensity, symptomatic duration, age of onset and Outerbridge grade.

scholarly journals Post-operative septic arthritis after arthroscopy: modern diagnostic and therapeutic concepts

2021 ◽  
Author(s):  
Andreas Voss ◽  
Christian G. Pfeifer ◽  
Maximilian Kerschbaum ◽  
Markus Rupp ◽  
Peter Angele ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Cell Count ◽  
Clinical Symptoms ◽  
Arthroscopic Surgery ◽  
Polymorphonuclear Cells ◽  
Level Of Evidence ◽  
Therapeutic Concepts ◽  
A Cell ◽  
Low Incidence ◽  
Joint Puncture

Abstract Purpose Septic arthritis is a significant complication following arthroscopic surgery, with an estimated overall incidence of less than 1%. Despite the low incidence, an appropriate diagnostic and therapeutic pathway is required to avoid serious long-term consequences, eradicate the infection, and ensure good treatment outcomes. The aim of this current review article is to summarize evidence-based literature regarding diagnostic and therapeutic options of post-operative septic arthritis after arthroscopy. Methods Through a literature review, up-to-date treatment algorithms and therapies have been identified. Additionally, a supportive new algorithm is proposed for diagnosis and treatment of suspected septic arthritis following arthroscopic intervention. Results A major challenge in diagnostics is the differentiation of the post-operative status between a non-infected hyperinflammatory joint versus septic arthritis, due to clinical symptoms, (e.g., rubor, calor, or tumor) can appear identical. Therefore, joint puncture for microbiological evaluation, especially for fast leukocyte cell-count diagnostics, is advocated. A cell count of more than 20.000 leukocyte/µl with more than 70% of polymorphonuclear cells is the generally accepted threshold for septic arthritis. Conclusion The therapy is based on arthroscopic or open surgical debridement for synovectomy and irrigation of the joint, in combination with an adequate antibiotic therapy for 6–12 weeks. Removal of indwelling hardware, such as interference screws for ACL repair or anchors for rotator cuff repair, is recommended in chronic cases. Level of evidence IV.

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.

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