2025 ISAKOS Biennial Congress ePoster
Ideal Remaining Meniscus Width and Risk Factors for Decrease of Meniscus Width after Reshaping Surgery in Pediatric Patients with Discoid Lateral Meniscus
Kyeong Baek Kim, MD, Yangsan-Si KOREA, REPUBLIC OF
Joon Ho Wang, MD, PhD, Seoul KOREA, REPUBLIC OF
Seong Man Jeon, MD, Seoul KOREA, REPUBLIC OF
Samsung medical center, Seoul, KOREA, REPUBLIC OF
FDA Status Not Applicable
Summary
This study found that the discoid lateral meniscus (DLM) significantly remodels to a more normal triangular shape within one year after arthroscopic partial meniscectomy and repair, with preoperative factors such as peripheral height, intrameniscal signal, and meniscal displacement influencing the decrease in meniscal width and the risk of extrusion.
Abstract
Purpose
This study aimed to determine the ideal remaining discoid meniscal width after reshaping surgery and investigate the preoperative risk factors for changes in the meniscal width.
Methods
We retrospectively analyzed 29 pediatric patients (39 knees) who underwent arthroscopic reshaping surgery for symptomatic discoid lateral meniscus (DLM) between 2016 and 2022. Magnetic resonance imaging (MRI) assessments were performed immediately after surgery and during at least one of the postoperative follow-ups, at 6 months or 1–2 years. Changes in the meniscal width were measured and analyzed and logistic regression was used to identify the preoperative risk factors for decreased meniscal width. Using receiver operating characteristic (ROC) curve analysis, we identified the cutoff values for preoperative factors and the remaining meniscal width after surgery that were associated with a residual meniscal width of less than 5 mm on the final MRI assessment.
Results
The meniscal width gradually decreased, particularly in the midbody (25.7% at 6 months and 38.1% at 1–2 years, postoperatively). Risk factors for width reduction included a complete-type DLM (β = 26.0, P = 0.036) and a smaller preoperative meniscal height (β = -4.51, P = 0.048). The ROC curve analysis indicated that a preoperative meniscal height of ≤3.3 mm and preserving a meniscal width of ≤8.5 mm after surgery may result in a residual meniscal width of less than 5 mm.
Conclusion
The ideal remaining meniscal width after reshaping surgery should be more than 8.5 mm. Clinicians should consider preserving the additional width if preoperative risk factors such as a complete DLM or a meniscal height of less than 3.3 mm, are present.