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A Comparison of Clinical Outcomes Of Discoid Versus Standard Meniscus Tear Procedures: A Systematic Review

A Comparison of Clinical Outcomes Of Discoid Versus Standard Meniscus Tear Procedures: A Systematic Review

Yi (David) Diao, BMSc, CANADA Prushoth Vivekanantha, MD, CANADA Dan Cohen, MD, CANADA Yuichi Hoshino, MD, PhD, JAPAN Kanto Nagai, MD, PhD, JAPAN Darren L. de SA, MD MBA FRCSC, CANADA

McMaster University, Hamilton, ON, CANADA


2023 Congress   ePoster Presentation   2023 Congress   rating (1)

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Diagnosis Method

Sports Medicine


Summary: Discoid saucerization procedures with or without stabilization leads to similar Lysholm, IKDC, and Tegner scores compared to non-discoid meniscectomy or repair procedures.


Purpose

To compare postoperative clinical outcomes of discoid meniscus tear procedures such as saucerization and saucerization with stabilization with those of non-discoid meniscus tears such as meniscectomy or repair in skeletally mature patients with no concomitant injuries.

Methods

Three databases MEDLINE, PubMed and EMBASE were searched from inception to July 3rd, 2022 for literature describing patient reported outcome measures after meniscus surgery in discoid or non-discoid meniscus tears. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Clinical outcome data on Lysholm, Tegner, IKDC, revision rate, and complications were recorded, with MINORS and Detsky scores used to perform quality assessment.

Results

A total of 44 studies comprising 3795 patients were included in this review with a mean age of 39.7 years (range: 9.0-64.4). The mean loss to follow up in each study was 10.3% (range: 0-57.3%) and the mean follow-up time was 49.4 months (range: 3-234). The average percentage of female participants in each study was 24.8% (range: 9.5-95.5). In the discoid meniscus group, eight studies (n=292) reported mean Lysholm scores ranging from 78.6-97.3. In the non-discoid meniscectomy group, nine studies (n=519) reported mean Lysholm scores ranging from 53.2-94.0 while in the non-discoid repair group, 17 studies (n=550) reported mean Lysholm scores ranging from 77.1-98.1. In the discoid meniscus group, four studies (n=172) reported mean Tegner scores ranging from 5.9-7.3 while in the non-discoid meniscectomy group, four studies (n=129) reported mean Tegner scores ranging from 3.0-4.8, and in the non-discoid repair group, seven studies (n=207) reported mean Tegner scores ranging from 3.0-5.5. In the discoid meniscus group, three studies (n=66) reported mean IKDC scores ranging from 77.4-96.0 while in the non-discoid meniscectomy group, nine studies (n=260) reported mean IKDC scores ranging from 46.9-85.7, and in the non-discoid repair group, 13 studies (n=426) reported mean IKDC scores ranging from 63.1-94.0. The revision rates for discoid procedures, non-discoid meniscectomies, and non-discoid meniscus repairs ranged from 3.2%-44.0%, 7.0%-56.0%, and 0.7%-28.0% respectively. The most common reasons for revision were acute trauma and persistent pain.

Conclusion

Discoid saucerization procedures with or without stabilization leads to similar Lysholm scores, IKDC scores and revision rates compared with non-discoid meniscectomy or repair procedures. Discoid patients appeared to have slightly higher Tegner activity scores compared with non-discoid patients; however, this is to be considered in the context of a younger population of discoid patients versus non-discoid patients due to limitations in the amount of available data. Information from this review can be used to inform patients with discoid menisci that they are likely to recover knee function equally as well as their morphologically normal counterparts.


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