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Abstract Presented at the 26th Annual Meeting of the Arthroscopy Association of North America| Volume 23, ISSUE 6, SUPPLEMENT , e16-e17, June 2007

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Arthroscopic Partial Meniscectomy with Repair of the Peripheral Tear for Symptomatic Discoid Lateral Meniscus in Children: Results of Minimum 2 Years Follow-up (SS-32)

      Summary

      The purpose of this study is to report the clinical results and the technical aspects of arthroscopic partial meniscectomy in conjunction with the repair of the peripheral tear for symptomatic discoid lateral meniscus in children. We retrospectively studied 24 patients (25 knees) had a peripheral tear that underwent partial central meniscectomy in conjunction with suture repair. All patients showed good clinical results with no reoperation after an average follow-up time of 59 months. We believe that the our technical guide in arthroscopic meniscal repair techniques, arthroscopic partial meniscectomy in conjunction with the repair of the peripheral tear can be effective method in patients with a symptomatic discoid lateral meniscus in children.

      Purpose

      A discoid lateral meniscus causes symptoms mainly in children and adolescents, usually as a result of a tear of the anterior or posterior segments. If the tears of a discoid meniscus at peripheral rim were not treated, the remnant meniscus can be unstable. The purpose of this study is to report the clinical results and the technical aspects of arthroscopic partial meniscectomy in conjunction with the repair of the peripheral tear for symptomatic discoid lateral meniscus in children.

      Methods

      From March 1997 to July 2004, the senior author performed arthroscopic surgery for patients with a symptomatic discoid lateral meniscus on 70 patients (74 knees) in children. Of these patients, 25 knees were observed a peripheral tear in the vascular zone of a discoid meniscus by arthroscopic evaluation. We retrospectively studied 24 patients (25 knees) had a peripheral tear that underwent partial central meniscectomy in conjunction with suture repair. The mean age at the time of operation was 9.2 years (range, 4 to 15 years) and the mean follow-up period was 59.3 months (range, 24 to 108 months). The partial central meniscectomy was performed in either a 1-piece or piecemeal fashion using arthroscopic instrument such as iris scissor, arthroscopic scissor or basket forceps. We found that 12 knees were a peripheral tear of anterior horn; 7, from midhorn to posterolateral corner; and 6, posterior horn. The tear was repaired as modified outside in technique if the segment was the anterior horn of the meniscus; modified inside-out technique, from midhorn to posterolateral corner; and all-inside technique, posterior horn with the absorbable sutures(No. 0 PDS: Ethicon, Sommerville, NJ, USA). The clinical results were evaluated according to Lysolm knee score and Hospital for Special Surgery (HSS) score at preoperatively and final follow-up.

      Results

      All patients showed good clinical results with no reoperation after an average follow-up time of 59 months. At final follow-up, full range of motion was achieved in all patients. However, there were 2 knees with limited function during squatting and jumping because of pain. The mean preoperative Lysholm knee score, which was 79.0 (range, 69-89), improved to 95.1 (range, 85-100) at final follow-up (p<0.0001). The mean preoperative HSS score, which was 80.1 (range, 69-89), improved to 96.1 (range, 90-100) at final follow-up (p<0.0001).

      Conclusions

      We believe that the our technical guide in arthroscopic meniscal repair techniques, arthroscopic partial meniscectomy in conjunction with the repair of the peripheral tear can be effective method in patients with a symptomatic discoid lateral meniscus in children.