Higher Rates of Mensical Repair and Rim Preservation in Younger Patients with Discoid Lateral Menisci. Issue 5 (31st May 2022)
- Record Type:
- Journal Article
- Title:
- Higher Rates of Mensical Repair and Rim Preservation in Younger Patients with Discoid Lateral Menisci. Issue 5 (31st May 2022)
- Main Title:
- Higher Rates of Mensical Repair and Rim Preservation in Younger Patients with Discoid Lateral Menisci
- Authors:
- Kemper, W. Craig
Adsit, Lizzie R.
Cooper, Savannah
McKay, Scott
Latz, Kevin
Shea, Kevin
Fabricant, Peter
Beck, Jennifer
Schmale, Gregory
Tenfelde, Allison
Gupta, Andrew
Green, Dan
Albright, Jay
Cardelia, Marc
Ellis, Henry B. - Abstract:
- Background: Management of discoid meniscus in pediatric patients requires understanding of the presentation, associated risks, and appropriate techniques. Surgical treatment consists of saucerization, meniscus repair, meniscocapular stabilization, and, periodically, subtotal meniscectomy. The type of meniscal treatment is commonly determined during arthroscopy. Thus, surgeons, patients, and their parents/guardians must be prepared for a variety of surgical options. Hypothesis/Purpose: To compare intraoperative arthroscopic findings and treatment of discoid meniscus across pediatric age groups in a large multicenter quality improvement registry. Methods: A multi-center quality improvement registry (16 institutions, 26 surgeons) monitoring the safety of discoid meniscus surgery was reviewed. Audit processes using CPT codes were designed to ensure that all consecutive cases from 2018-2020 were prospectively entered on patients <19 years old into a HIPAA-compliant electronic platform. Patients were grouped into five groups based on age at time of surgery (<7, 7-10, 11-13, 14-16, >16). Demographic characteristics, discoid type, presence and type of tear, peripheral rim instability, repair technique, and partial meniscectomy/debridement beyond saucerization were reviewed. Chi-Square or Fisher's exact tests were used for categorical comparisons and a Kruskal-Wallis test for continuous comparisons. Results: 274 patients were identified (mean age 12.4 years, range 3-18; 47.3%Background: Management of discoid meniscus in pediatric patients requires understanding of the presentation, associated risks, and appropriate techniques. Surgical treatment consists of saucerization, meniscus repair, meniscocapular stabilization, and, periodically, subtotal meniscectomy. The type of meniscal treatment is commonly determined during arthroscopy. Thus, surgeons, patients, and their parents/guardians must be prepared for a variety of surgical options. Hypothesis/Purpose: To compare intraoperative arthroscopic findings and treatment of discoid meniscus across pediatric age groups in a large multicenter quality improvement registry. Methods: A multi-center quality improvement registry (16 institutions, 26 surgeons) monitoring the safety of discoid meniscus surgery was reviewed. Audit processes using CPT codes were designed to ensure that all consecutive cases from 2018-2020 were prospectively entered on patients <19 years old into a HIPAA-compliant electronic platform. Patients were grouped into five groups based on age at time of surgery (<7, 7-10, 11-13, 14-16, >16). Demographic characteristics, discoid type, presence and type of tear, peripheral rim instability, repair technique, and partial meniscectomy/debridement beyond saucerization were reviewed. Chi-Square or Fisher's exact tests were used for categorical comparisons and a Kruskal-Wallis test for continuous comparisons. Results: 274 patients were identified (mean age 12.4 years, range 3-18; 47.3% females). Complete discoid meniscus and peripheral rim instability were found to be more prevalent in younger age groups (Table 1). Peripheral rim instability was noted in 55.5% of cases, most commonly in the posterior horn (24.8%). While a focal region of instability was most common, the youngest age group was more likely to have either multifocal instability or no instability. Repair was conducted more commonly in the younger cohorts, with a significant decrease in repair percentage (p=0.008) per age group. All-inside was the most common repair technique in all age groups. Partial meniscectomy/debridement beyond saucerization occurred more frequently in older age groups than younger age groups (p=.0002), including 38.4% of cases in the oldest age group (Table 2). Conclusion: Younger patients experienced a greater incidence of complete discoid menisci and meniscus repair in this age group and was more likely to have more than one area of rim instability. However, when meniscal resection beyond a saucerization was required, this was more likely to occur in older patients. Table 1. Age-Related Comparison of Discoid Meniscal Presentation and Treatment Table 2. Incidence of Additional Meniscal Resection Beyond Saucerization … (more)
- Is Part Of:
- Orthopaedic journal of sports medicine. Volume 10:Issue 5(2022)Supplement 2
- Journal:
- Orthopaedic journal of sports medicine
- Issue:
- Volume 10:Issue 5(2022)Supplement 2
- Issue Display:
- Volume 10, Issue 5, Part 2 (2022)
- Year:
- 2022
- Volume:
- 10
- Issue:
- 5
- Part:
- 2
- Issue Sort Value:
- 2022-0010-0005-0002
- Page Start:
- Page End:
- Publication Date:
- 2022-05-31
- Subjects:
- Sports medicine -- Periodicals
Orthopedics -- Periodicals
Arthroscopy -- Periodicals
Arthroplasty -- Periodicals
Knee -- Surgery -- Periodicals
616.7 - Journal URLs:
- http://www.sagepublications.com/ ↗
- DOI:
- 10.1177/2325967121S00423 ↗
- Languages:
- English
- ISSNs:
- 2325-9671
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
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- 22947.xml