Chinese Experts Consensus and Practice Guideline on Discoid Lateral Meniscus. Issue 4 (6th March 2023)

• Record Type: Journal Article
• Authors: Yang, Shunjie; Zhang, Shurong; Li, Ruixin; Yang, Chunxi; Zheng, Jiapeng; Wang, Cheng; Lu, Jun; Zhang, Zhengzheng; Shang, Xiliang; Zhang, Hui; Wang, Weiming; Li, Weiping; Huang, Jingmin; Zhang, Yadong; Wang, Jianquan; Wang, You; Zheng, Xiaofei; Chen, Gang; Hua, Yinghui; Chen, Shiyi; Li, Jian
• Is Part Of: Orthopaedic surgery. Volume 15:Issue 4(2023)
• Page Start: 915
• Page End: 929
• Publication Date: 2023-03-06
• Subjects: Consensus -- Diagnosis -- Discoid Lateral Meniscus -- Guideline -- Treatment; Orthopedic surgery -- Periodicals; Orthopedics -- Periodicals; Musculoskeletal system -- Wounds and injuries -- Periodicals; 617.47005
• DOI: 10.1111/os.13687
• Languages: English
• ISSNs: 1757-7853

Abstract

Abstract : Discoid lateral meniscus (DLM) is the most common congenital variant of the lateral meniscus, which is prone to degeneration and lesions, and often leads to knee osteoarthritis. At present, there is no consensus on the clinical practice of DLM, and this expert consensus and practice guidelines on DLM was developed and approved by Chinese Society of Sports Medicine according to the Delphi method. Among 32 statements drafted, 14 statements were excluded for redundant information, and 18 statements achieved consensus. This expert consensus focused on the definition, epidemiology, etiology, classification, clinical manifestations, diagnosis, treatment, prognosis, and rehabilitation of DLM. Restoring the normal shape, retaining appropriate width and thickness, and ensuring the stability of the remnant meniscus is critical to sustaining the physiological function of the meniscus and preserving the knee. The partial meniscectomy with or without repair should be the first‐line treatment when possible, given that the clinical and radiological long‐term outcomes of total or subtotal meniscectomy are worse. Abstract : The China Sports Medicine Association established the expert consensus for DLM from July 31, 2021, to December 26, 2021, focusing on the definition, epidemiology, etiology, classification, clinical manifestations, diagnosis, treatment, prognosis, and rehabilitation. NLM lesions will be discussed in another consensus. The process of this consensus followed the Delphi method. A total of 60 experts with extensive experience in the fields of sports medicine and orthopaedics were invited and divided into the steering group (n = 9), the rating group (n = 36), and the peer review group (n = 15). First, the steering group developed a series of statements (question and answer sets) based on a comprehensive literature review. Afterward, these statements were submitted to and reviewed by the rating group. Based on the scientific evidence and the clinical experience of raters, each member of the rating group was asked to anonymously score each statement on a Likert scale ranging from 1 (totally inappropriate) to 5 (totally appropriate) points. Then, according to the voting result and the discussion of the rating group, the statements were endorsed or revised correspondingly. If the proportion of favorable votes was 80% or above, the statement was defined as the consensus, and its content needed to be revised if inconsistent opinions were proposed and supported by the other two participants. If 50% or less, the issue was not passed. If between 50% to 80%, the statement with its suggestion was returned to the steering group for revision, and the second draft was prepared and resubmitted to the rating group for discussing and voting again at the steering and rating group's combined meeting. Once the consensus was reached between the steering and rating groups, the comments were sent to the steering group for the third draft. Finally, the third draft was sent to the peer review group to evaluate and determine the feasibility, accessibility, and readability of the proposed recommendations. The steering group drafted 32 statements on DLM. After the first review by the rating group, 14 statements were excluded for redundant information. Finally, 18 statements achieved consensus, of which 16 statements were unanimity. The mean point assigned by each rater ranged from 4.69 to 4.97 points. The mean point by the rating group was 4.86 (95% CI 4.81–4.90).