Summary

Arthroscopic partial central meniscectomy is considered a classic method of treatment of discoid meniscus type III (Watanabe). Meniscus extrusion is a frequent complication of this operation. The use of additional stabilization sutures of the meniscus to the joint capsule prevents the extrusion of the meniscus, which improves the functional state of the knee joint in the postoperative period.

Abstract

Objective.
Arthroscopic partial central meniscectomy is considered to be the classic method for the treatment of discoid meniscus type IIІ (Watanabe classification, 1969), during which the width and volume of the meniscus are restored to normal values. A frequent problem of treatment with this technique is extrusion of the meniscus, which causes discomfort to patients in the postoperative period. The use of additional stabilizing sutures of the meniscus to the joint capsule after partial meniscectomy prevents extrusion of the meniscus, which improves the functional status of patients in the postoperative period.

Material and Methods.
18 patients (men and women aged 18-45) with discoid lateral meniscus type III (classification of Watanabe, 1969) were included. The diagnosis was confirmed by an MRI. Patients were divided into 2 groups. The main group included patients with using additional stabilization sutures after partial central meniscectomy under arthroscopic control (n=9). The comparison group – partial central meniscectomy (n=9). Patients of both study groups were assessed for the functional state of the knee joint according to the Lysholm scale and meniscal extrusion before surgery and 12 months after surgery.

Result.
In the main group of the patients with discoid lateral meniscus type IIІ, the score on the Lysholm scale was 63,5±4,4 points before the operation, in the comparison group of the patients - 63,8±4,2 points (p<0,05). The average value of extrusion distance before surgery was obtained 3.3 ± 0.6 mm (p < 0,05) for main and comparison groups. Patients in the main group underwent a partial central meniscectomy, suturing of the meniscus using the inside-out suture technique for fixation meniscus to capsule under arthroscopic control. Patients in the comparison group underwent a partial central meniscectomy under arthroscopic control without the use of additional sutures. 12 months after surgery, the extrusion distance of the main group was 2.2 ± 0.4 mm (p < 0.05) and 3.5 ± 0.4 mm (p < 0.05) of the comparison group. The score on the Lyscholm scale in the patients of the main group was 86,8±4,1 points (p < 0.05), in the comparison group - 80,5±3,5 points (p <0.05).

Conclusions.
Additional methods of stabilization of the lateral meniscus in discoid lateral meniscus improved the functional status of the knee joint and the results of the treatment of extrusion of the lateral meniscus in patients. This method will improve the functional state of the patient's joint in the postoperative period and reduce the load on the lateral meniscus in the form of extrusion.

Keywords: discoid lateral meniscus, partial central meniscectomy, Lysholm scale, lateral meniscus extrusion, additional stabilization sutures.