TY - JOUR
T1 - Relationship Between Age and Pathology With Treatment of Pediatric and Adolescent Discoid Lateral Meniscus
T2 - A Report From the SCORE Multicenter Database
AU - Members of the SCORE Quality Improvement Registry
AU - Adsit, Elizabeth
AU - Albright, Jay
AU - Algan, Sheila
AU - Beck, Jennifer
AU - Bowen, Richard E.
AU - Brey, Jennifer
AU - Marc Cardelia, J.
AU - Clark, Christian
AU - Coello, Pablo
AU - Crepeau, Allison
AU - Edmonds, Eric
AU - Ellington, Matthew
AU - Ellis, Henry B.
AU - Fabricant, Peter D.
AU - Frank, Jeremy S.
AU - Ganley, Theodore J.
AU - Green, Daniel W.
AU - Gupta, Andrew
AU - Heyworth, Benton
AU - Kemper, W. Craig
AU - Latz, Kevin
AU - Mansour, Alfred
AU - Mayer, Stephanie
AU - McKay, Scott D.
AU - Milewski, Matthew D.
AU - Niu, Emily
AU - Pacicca, Donna M.
AU - Parikh, Shital N.
AU - Pupa, Lauren
AU - Rhodes, Jason
AU - Saper, Michael
AU - Schmale, Gregory A.
AU - Schmitz, Matthew
AU - Shea, Kevin
AU - Silverstein, Rachel S.
AU - Storer, Stephen
AU - Wilson, Philip L.
N1 - Publisher Copyright:
© 2023 The Author(s).
PY - 2023/11
Y1 - 2023/11
N2 - Background: Surgical treatment options of discoid lateral meniscus in pediatric patients consist of saucerization with or without meniscal repair, meniscocapular stabilization, and, less often, subtotal meniscectomy. Purpose: To describe a large, prospectively collected multicenter cohort of discoid menisci undergoing surgical intervention, and further investigate corresponding treatment of discoid menisci. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter quality improvement registry (16 institutions, 26 surgeons), Sports Cohort Outcomes Registry, was queried. Patient characteristics, discoid type, presence and type of intrasubstance meniscal tear, peripheral rim instability, repair technique, and partial meniscectomy/debridement beyond saucerization were reviewed. Discoid meniscus characteristics were compared between age groups (<14 and >14 years old), based on receiver operating characteristic curve, and discoid morphology (complete and incomplete). Results: In total, 274 patients were identified (mean age, 12.4 years; range, 3-18 years), of whom 55.6% had complete discoid. Meniscal repairs were performed in 55.1% of patients. Overall, 48.5% of patients had rim instability and 36.8% had >1 location of peripheral rim instability. Of the patients, 21.5% underwent meniscal debridement beyond saucerization, with 8.4% undergoing a subtotal meniscectomy. Patients <14 years of age were more likely to have a complete discoid meniscus (P <.001), peripheral rim instability (P =.005), and longitudinal tears (P =.015) and require a meniscal repair (P <.001). Patients ≥14 years of age were more likely to have a radial/oblique tear (P =.015) and require additional debridement beyond the physiologic rim (P =.003). Overall, 70% of patients <14 years of age were found to have a complete discoid meniscus necessitating saucerization, and >50% in this young age group required peripheral stabilization/repair. Conclusion: To preserve physiological “normal” meniscus, a repair may be indicated in >50% of patients <14 years of age but occurred in <50% of those >14 years. Additional resection beyond the physiological rim may be needed in 15% of younger patients and 30% of those aged >14 years.
AB - Background: Surgical treatment options of discoid lateral meniscus in pediatric patients consist of saucerization with or without meniscal repair, meniscocapular stabilization, and, less often, subtotal meniscectomy. Purpose: To describe a large, prospectively collected multicenter cohort of discoid menisci undergoing surgical intervention, and further investigate corresponding treatment of discoid menisci. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter quality improvement registry (16 institutions, 26 surgeons), Sports Cohort Outcomes Registry, was queried. Patient characteristics, discoid type, presence and type of intrasubstance meniscal tear, peripheral rim instability, repair technique, and partial meniscectomy/debridement beyond saucerization were reviewed. Discoid meniscus characteristics were compared between age groups (<14 and >14 years old), based on receiver operating characteristic curve, and discoid morphology (complete and incomplete). Results: In total, 274 patients were identified (mean age, 12.4 years; range, 3-18 years), of whom 55.6% had complete discoid. Meniscal repairs were performed in 55.1% of patients. Overall, 48.5% of patients had rim instability and 36.8% had >1 location of peripheral rim instability. Of the patients, 21.5% underwent meniscal debridement beyond saucerization, with 8.4% undergoing a subtotal meniscectomy. Patients <14 years of age were more likely to have a complete discoid meniscus (P <.001), peripheral rim instability (P =.005), and longitudinal tears (P =.015) and require a meniscal repair (P <.001). Patients ≥14 years of age were more likely to have a radial/oblique tear (P =.015) and require additional debridement beyond the physiologic rim (P =.003). Overall, 70% of patients <14 years of age were found to have a complete discoid meniscus necessitating saucerization, and >50% in this young age group required peripheral stabilization/repair. Conclusion: To preserve physiological “normal” meniscus, a repair may be indicated in >50% of patients <14 years of age but occurred in <50% of those >14 years. Additional resection beyond the physiological rim may be needed in 15% of younger patients and 30% of those aged >14 years.
KW - discoid meniscus
KW - instability
KW - meniscal tear
KW - pediatric
KW - saucerization
UR - http://www.scopus.com/inward/record.url?scp=85176135534&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85176135534&partnerID=8YFLogxK
U2 - 10.1177/03635465231206173
DO - 10.1177/03635465231206173
M3 - Article
C2 - 37899536
AN - SCOPUS:85176135534
SN - 0363-5465
VL - 51
SP - 3493
EP - 3501
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
IS - 13
ER -