Efficacy of arthroscopic surgery for discoid lateral meniscus injury in knee joint: a self-control study

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.

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Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

10.21203/rs.2.19197/v3 ◽

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.

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Clinical Diagnostic Value of Magnetic Resonance Imaging in Knee Joint Sports Injury

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3301 ◽

2021 ◽

Vol 11 (2) ◽

pp. 453-461

Author(s):

Bing Wang ◽

Li Wang ◽

Yingyi Wang ◽

Fen Qin

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Knee Joint ◽

Clinical Judgment ◽

Lateral Meniscus ◽

Clinical Effects ◽

Resonance Imaging ◽

Knee Meniscus ◽

Meniscus Injury ◽

Sensitivity Specificity

This article mainly analyzes the clinical effects of magnetic resonance diagnosis in knee meniscus injury. Patients with knee meniscus injury were taken as the research object. All patients used magnetic resonance examination and surgery and arthroscopy examination, and surgery and arthroscopy examination as the control parameters. The analysis used magnetic resonance diagnosis results and the classification of meniscus injury diagnosed by magnetic resonance and surgery and arthroscopy. The results showed that the sensitivity, specificity, and accuracy of conventional MR1 sequence diagnosis of medial meniscus injury were 86.3%, 95.6%, and 92.4%, respectively. The sensitivity, specificity and accuracy of conventional MRI in diagnosing lateral meniscus injury of the knee joint were 91.3%, 94.5%, and 92.5% respectively. The sensitivity of MRI to medial and lateral meniscus injury was (χ2 = 0.07, P > 0.77), There were no significant differences in specificity χ2 = 0.01, P > 0.77) and accuracy χ2 = 0.01, P > 0.77). The knee meniscus injury has a greater impact on patients. The diagnostic effect of magnetic resonance imaging is better and the diagnostic accuracy is higher. It can help clinical judgment and treatment. The effect is obvious and worthy of clinical promotion.

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Discoid Lateral Meniscus of the Knee Joint

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-195739010-00008 ◽

1957 ◽

Vol 39 (1) ◽

pp. 77-87 ◽

Cited By ~ 95

Keyword(s):

Knee Joint ◽

Lateral Meniscus ◽

Discoid Lateral Meniscus

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A case report of discoid medial meniscus injury with discoid lateral meniscus.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.34.1303 ◽

1986 ◽

Vol 34 (4) ◽

pp. 1303-1305

Author(s):

Kazutoshi Nomura ◽

Jiro Mizuoka ◽

Terumi Sakae ◽

Hikaru Tajima

Keyword(s):

Case Report ◽

Medial Meniscus ◽

Lateral Meniscus ◽

Discoid Lateral Meniscus ◽

Meniscus Injury ◽

Discoid Medial Meniscus

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Discoid Lateral Meniscus of the Knee Joint

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-196244040-00028 ◽

1962 ◽

Vol 44 (4) ◽

pp. 811

Author(s):

Emanuel B. Kaplan

Keyword(s):

Knee Joint ◽

Lateral Meniscus ◽

Discoid Lateral Meniscus

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Effect of arthroscopic surgery combined with platelet-rich plasma in the treatment of discoid meniscus injury of knee joint and its influence on serum inflammatory factors

European Journal of Inflammation ◽

10.1177/2058739218814334 ◽

2019 ◽

Vol 17 ◽

pp. 205873921881433

Author(s):

Jia Liu

Keyword(s):

Knee Joint ◽

Platelet Rich Plasma ◽

Arthroscopic Surgery ◽

Inflammatory Factors ◽

Control Group ◽

Study Group ◽

Discoid Meniscus ◽

Meniscus Injury ◽

Tnf Α ◽

Significant Difference

This study was to observe the effect of arthroscopic surgery combined with platelet-rich plasma (PRP) in the treatment of discoid meniscus injury of knee joint and its influence on serum inflammatory factors. A total of 80 patients with discoid meniscus injury in our hospital from June 2014 to June 2016 were enrolled and divided into study group and control group randomly with 40 patients in each group. The control group was treated with arthroscopy alone, and the study group was treated with arthroscopy combined with PRP. The clinical efficacy of the two groups was observed, and the Lysholm scores, Knee injury and Osteoarthritis Outcome Score (KOOS scores), and serum inflammatory factors (IL-1, TNF-α, and IL-6) were compared between the two groups before and after treatment. Six months after the treatment, the improvement rate, defined as (Excellent + Good)/total*100, of the study group was 97.5%, significantly higher than that of the control group, which was 87.5% ( P < 0.05); before treatment, there was no significant difference in both Lysholm scores and KOOS scores between the two groups ( P > 0.05); and 6 months later, the Lysholm scores and KOOS scores in the two groups were both significantly higher than those before, and the scores in the study group increased more significantly compared with those of the control group ( P < 0.05); the values of serum IL-1, TNF-α, and IL-6 in the two groups were both significantly lower than those before, and the values in the study group decreased more significantly compared with those of the control group ( P < 0.05). In conclusion, arthroscopic surgery combined with PRP therapy can effectively improve the clinical symptoms and reduce the level of serum inflammatory factors in patients with discoid meniscus injury of the knee, which is worthy of promotion and application.

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