2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Is It Worth Repairing Unstable Discoid Meniscus?: A Long-term Analysis Following Discoid Meniscus Repair with a Minimum of 5 Years Follow Up

Mauricio Drummond, Jr., MD, Astoria, NY UNITED STATES
Steven Henick, MD, Bronx, NY UNITED STATES
Joseph Nicholas Charla, MS, Bronx, NY UNITED STATES
Emily Ferreri, BS, Bronx, NY UNITED STATES
Emmanuel Mbamalu, MS, Bronx, NY UNITED STATES
Leila M. Alvandi, PhD, Bronx UNITED STATES
Edina Gjonbalaj, BS, Bronx UNITED STATES
Jacob Schulz, Bronx, NY UNITED STATES
Eric D. Fornari, MD, Mount Kisco, NY UNITED STATES

Monteefiore Einstein, Bronx, NY, UNITED STATES

FDA Status Not Applicable

Summary

The majority (95%) of patients returned to their pre-injury function level at a minimum of 5 years of follow-up from DM surgery and at a median of 7 years post-operatively. Long term subgroup analysis demonstrated better PROs in the DM repair group compared with non-repair group.

Abstract

Objectives:
Discoid meniscus (DM) repair is the gold standard treatment for unstable DM. Good early clinical outcomes have been reported following DM repair, however, it is unclear if these outcomes can be sustained over time due to the dearth of long-term studies. The purpose of this study is to report the clinical outcomes following DM repair with a minimum of 5 years of follow-up.

Methods

This is a retrospective review of patients under 21 years old who underwent arthroscopic treatment for DM from 2014 to 2023 with a minimum of 5-year follow-up. Patients with stable DM underwent saucerization, and those with unstable DM had saucerization with meniscal repair. Data collection included demographics, clinical presentation, meniscal pathology, surgical technique, re-operation and complication rates. Patient reported outcome (PRO) scores were collected post-operatively starting at the 1- year follow-up. Patients were called at final follow-up to confirm their function level. Wilcoxon rank-sum tests compared the PRO scores between the stable and unstable meniscus groups.

Results

There were 39 patients who underwent surgical management at a mean age 13.13 ± 3.75 years with a median follow-up time of 7.36 years (IQR 4.96 – 7.98). Of these, 18 (46.1%) had stable and 21 (53.9%) had unstable DM. Patients that presented with unstable DM were younger (12.2 vs 14.1, p< 0.001) and had fewer chondral lesions (0 vs 4, p=0.04). Of the 39 patients called at final follow-up, 38 responded (97.4%). Both stable and unstable DM groups reported high rate of return to pre-injury level (94.4% vs 95%, p=0.99),and low and similar reoperation rate ( 2/18, 11% vs 1/20, 4.7%; p=0.59). Subgroup analysis at a median 7.36 years from surgery demonstrated significantly better PROs for the repair group compared to the non-repair group as seen on Tengner Lysholm (99.0 vs 85.5, p=0.02), Pedi-IKDC (98.3 vs 88.5, p< 0.01), KOOS Child Symptom (100 vs 87.8, p<0.01), KOOS Child Pain (100 vs 91,p=0.39), KOOS Child ADL (100 vs 99.0, p=0.04), KOOS Child Sport (95 vs 96, p=0.99)and KOOS Child QOL (100 vs 83.5, p=0.24) PROs.

Conclusion

The majority (95%) of patients returned to their pre-injury function level at a minimum of 5 years of follow-up from DM surgery and at a median of 7 years post-operatively. Long term subgroup analysis demonstrated better PROs in the DM repair group compared with non-repair group. Our findings support DM preservation surgery as an effective and safe technique that leads to sustainable long-term clinical outcomes.