Arthroscopic central meniscectomy and peripheral suture for discoid lateral meniscal tears in children

XU Qing-lei; LI Fei; HAN Guo-yi; WANG Bin

doi:10.3969/j.issn.2095-252X.2015.04.004

Abstract：Objective To evaluate the clinical outcomes of surgical treatment of discoid lateral meniscal tears in children by arthroscopic central meniscectomy and peripheral suture.Methods A retrospective analysis was performed on 69 patients ( 87 knees ) with discoid lateral meniscal tears who were treated by arthroscopic surgery. According to diagnostic arthroscopic examination results, 27 patients ( 31 knees ) were classiifed as meniscocapsular junction anterior horn ( MC-A ) type, meniscocapsular junction posterior horn ( MC-P ) type and posterolateral corner ( PLC ) type. After central meniscectomy, the peripheral tears were repaired by outside-in technique in MC-A type and inside-out or all-inside technique in MC-P type and PLC type. Twenty-ifve patients ( 27 knees ) were followed up for an average period of 52.6 months ( range: 24-92 months ). Among the 25 patients, there were 2 patients ( 2 knees ) under 6 years old with the average body weight of 17.5 kg, 12 patients ( 13 knees ) between 7 to 12 years old with the average body weight of 35.8 kg, and 11 patients ( 12 knees ) between 12 to 14 years old with the average body weight of 42.2 kg. The preoperative and postoperative Lysholm scores were compared.Results All the patients complained of preoperative extension block, joint clicking and bouncing, mechanical locking and joint line tenderness, which disappeared completely after the operation. Based on the diagnostic arthroscopic examination, there were 7 cases of MC-A type, 9 cases of MC-P type and 11 cases of PLC type. The mean Lysholm score was increased from 71.8 ( range: 62-82 ) preoperatively to 97.1 ( range: 90-100 ) postoperatively (P<0.0001 ).Conclusions Satisfactory clinical outcomes can be achieved in the children with discoid lateral meniscal tears with the treatment of arthroscopic central meniscectomy and peripheral suture by outside-in, inside-out and all-inside technique, and the injured menisci can be saved as much as possible. The long-term complications of total meniscectomy can also be avoided.