EFFECTIVENESS OF ARTHROSCOPIC TREATMENT FOR LATERAL DISCOID MENISCUS INJURIES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HU Kejia ¹ , FENG Dehong ² , WANG Ling ² , SUN Zhenzhong ¹ , RUI Yongjun ¹

1Department of Orthopedics, Wuxi No.9 People’s Hospital Affiliated to Soochow University &;
Wuxi Hand Surgery Hospital, Wuxi Jiangsu, 214062, P.R.China;;
2Department of Orthopedics, Wuxi People’s Hospital Affiliated to Nanjing Medical University. Corresponding author: HU Kejia, E-mail: winnie_coka@126.com;

Corresponding author：

Keywords：

Lateral discoid meniscus injury; Arthroscopy; Meniscus plasty and suture; Partial meniscectomy; Complete meniscectomy

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Objective To evaluate the surgical technique and effectiveness of arthroscopic treatment for lateral discoid meniscus injury. Methods Between January 2010 and May 2011, 38 patients (42 knees) with lateral discoid meniscus injuries underwent arthroscopic treatment. There were 23 males (24 knees) and 15 females (18 knees), aged 7-62 years (median, 32.8 years). The disease duration was 7 days to 40 years (median, 8.6 months). According to Watanabe’s classification of discoid meniscus, 22 knees were classified as complete type, 19 knees as incomplete type, and 1 knee as Wrisberg type. Meniscus plasty combined with suture was performed in 25 patients (28 knees), partial meniscectomy in 12 patients (13 knees), and complete meniscectomy in 1 patient (1 knee). After operation, the rehabilitation training programs (including straight-leg-raising exercise and range of motion exercise) were carried out. Results All incisions healed primarily. The patients basically had normal activities after 3-4 weeks. All the patient were followed up 12-18 months (mean, 14.3 months). No joint locked or clicking symptom occurred; no tear or revision was noted during follow-up. At 3 months, 6 months, and 1 year after operation, the range of flexion and extension were significantly improved when compared with ones at preoperation (P lt; 0.05). Based on Ikeuchi’s grading, the results were excellent in 22 knees, good in 16 knees, and fair in 4 knees with an excellent and good rate of 90.4%. The Lysholm score was significantly increased to 88.57 ± 2.95 at immediate, 91.02 ± 4.17 at 3 months, 92.90 ± 3.36 at 6 months, and 94.74 ± 3.52 at 12 months after operation from 69.38 ± 4.59 before operation (P lt; 0.05). C onclusion Treatment of lateral discoid meniscus injury under arthroscopy has the advantages of minor trauma, precise resection or repair meniscus, preservation of more meniscus function, and low incidence of osteoarthritis. If the operation is combined with standard rehabilitation training, the short-term effectiveness can be enhanced.

Citation： HU Kejia,FENG Dehong,WANG Ling,SUN Zhenzhong,RUI Yongjun. EFFECTIVENESS OF ARTHROSCOPIC TREATMENT FOR LATERAL DISCOID MENISCUS INJURIES. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(12): 1457-1461. doi: Copy

1.	Rohren EM, Kosarek FJ, Helms CA. Discoid lateral meniscus and the frequency of meniscal tears. Skeletal Radiol, 2001, 30(6): 316-320.
2.	O’Connor. O’Connor关节镜外科学. 陈峥嵘, 译. 上海: 复旦大学出版社, 2001: 381-382.
3.	徐海斌, 赵斌, 余占洪, 等. 膝关节镜下治疗半月板损伤30例疗效分析. 中国骨伤, 2004, 17(7): 421-422.
4.	高继宗, 王亦璁, 毕玉蝉. 半月板无血管区陈旧性裂伤愈合实验研究. 中华外科杂志, 1990, 28(12): 726-729.
5.	Ding J, Zhao J, He Y, et al. Risk factors for articular cartilage lesionsin symptomatic discoid lateral meniscus. Arthroscopy, 2009, 25(12): 1423-1426.
6.	Ikeuchi H. Arthroscopic treatment of the discoid lateral menicus. Technique and long-term results. Clin Orthop Relat Res, 1982, (167): 19-28.
7.	Bin SI, Jeong SI, Kim JM, et al. Arthroscopic partial meniscectomy for horizontal tear of discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2002, 10(1): 20-24.
8.	王晓宁, 杨柳, 文亚明, 等. 膝关节半月板损伤MRI表现与关节镜下表现的临床对比研究. 重庆医学, 2006, 35(13): 1154-1158.
9.	戴刚, 张卫东, 王东武, 等. 关节镜下手术治疗膝半月板损伤478例流行病学调查分析. 重庆医学, 2006, 35(13): 1168-1170.
10.	Atay OA, Doral MN, Leble G, et al. Management of discoid lateral meniscus tears: observations in 34 knees. Arthroscopy, 2003, 19(4): 346-352.
11.	Lu Y, Li Q, Hao J. Torn discoid lateral meniscus treated with arthroscopic meniscectomy: observations in 62 knees. Chin Med J (Eng), 2007, 120(3): 211-215.
12.	房传武, 郭涛, 祝宗华. 关节镜下手术治疗盘状半月板损伤. 临床骨科杂志, 2007, 10(3): 237-238.
13.	陈竹生, 王昆, 金文涛. 膝关节镜下手术治疗盘状半月板损伤. 国际医药卫生导报, 2007, 13(7): 26-28.
14.	陈游, 孙材江, 张薇. 膝关节镜视下盘状半月板成型术. 湖南医科大学学报, 2000, 25(2): 169-170.
15.	Stone KR, Adelson WS, Pelsis JR, et al. Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage: a prospective two- to 12-year follow-up report. J Bone Joint Surg (Br), 2010, 92(7): 941-948.
16.	Dienst M, Greis PE, Ellis BJ, et al. Effect of lateral meniscal allograft sizing on contact mechanics of the lateral tibial plateau: an experimental study in human cadaveric knee joints. Am J Sports Med, 2007, 35(1): 34-42.
17.	黄长征, 范伟杰, 陈志伟, 等. 成形联合修补术在盘状半月板损伤治疗中的应用. 中国骨伤, 2010, 23(6): 409-412.
18.	王友, 侯筱魁, 王以友, 等. 关节镜下半月板缝合技术的生物力学分析. 中华外科杂志, 1997, 35(2): 128.
19.	童学波, 俞辉国, 何国础. 关节镜下手术治疗儿童膝关节盘状软骨. 中华小儿外科杂志, 2003, 24(5): 443-445.
20.	Boyd KT, Myers PT. Meniscus preservation: rationale, repair techniques and results. Knee, 2003, 10(1): 10-11.
21.	Spahn G. Arthroseopic revisions in failed meniscal surgery. Int Orthop, 2003, 27(6): 378-381.
22.	McGinty JB. Operative arthroscopy. New York: Raven, 1996: 288-291.
23.	鲁英, 谭维溢. 膝关节镜下半月板手术后康复训练的疗效. 中华物理医学与康复杂志, 2002, 24(9): 559-560.
24.	杨晓, 黄崇新, 王跃. 膝关节盘状半月板损伤的关节镜手术治疗. 西部医学, 2009, 21(2): 264.
25.	Washington ER, Root L, Liener UC. Discoid lateral meniscus in children long-term follow-up after excision. J Bone Joint Surg (Am), 1995, 77(9): 1357-1361.
26.	Jung KA, Lee SC, Hwang SH. ‘Suture-induced tear’ after human meniscal allograft transplantation. Knee, 2010, 17(1): 88-91.

1. Rohren EM, Kosarek FJ, Helms CA. Discoid lateral meniscus and the frequency of meniscal tears. Skeletal Radiol, 2001, 30(6): 316-320.
2. O’Connor. O’Connor关节镜外科学. 陈峥嵘, 译. 上海: 复旦大学出版社, 2001: 381-382.
3. 徐海斌, 赵斌, 余占洪, 等. 膝关节镜下治疗半月板损伤30例疗效分析. 中国骨伤, 2004, 17(7): 421-422.
4. 高继宗, 王亦璁, 毕玉蝉. 半月板无血管区陈旧性裂伤愈合实验研究. 中华外科杂志, 1990, 28(12): 726-729.
5. Ding J, Zhao J, He Y, et al. Risk factors for articular cartilage lesionsin symptomatic discoid lateral meniscus. Arthroscopy, 2009, 25(12): 1423-1426.
6. Ikeuchi H. Arthroscopic treatment of the discoid lateral menicus. Technique and long-term results. Clin Orthop Relat Res, 1982, (167): 19-28.
7. Bin SI, Jeong SI, Kim JM, et al. Arthroscopic partial meniscectomy for horizontal tear of discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2002, 10(1): 20-24.
8. 王晓宁, 杨柳, 文亚明, 等. 膝关节半月板损伤MRI表现与关节镜下表现的临床对比研究. 重庆医学, 2006, 35(13): 1154-1158.
9. 戴刚, 张卫东, 王东武, 等. 关节镜下手术治疗膝半月板损伤478例流行病学调查分析. 重庆医学, 2006, 35(13): 1168-1170.
10. Atay OA, Doral MN, Leble G, et al. Management of discoid lateral meniscus tears: observations in 34 knees. Arthroscopy, 2003, 19(4): 346-352.
11. Lu Y, Li Q, Hao J. Torn discoid lateral meniscus treated with arthroscopic meniscectomy: observations in 62 knees. Chin Med J (Eng), 2007, 120(3): 211-215.
12. 房传武, 郭涛, 祝宗华. 关节镜下手术治疗盘状半月板损伤. 临床骨科杂志, 2007, 10(3): 237-238.
13. 陈竹生, 王昆, 金文涛. 膝关节镜下手术治疗盘状半月板损伤. 国际医药卫生导报, 2007, 13(7): 26-28.
14. 陈游, 孙材江, 张薇. 膝关节镜视下盘状半月板成型术. 湖南医科大学学报, 2000, 25(2): 169-170.
15. Stone KR, Adelson WS, Pelsis JR, et al. Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage: a prospective two- to 12-year follow-up report. J Bone Joint Surg (Br), 2010, 92(7): 941-948.
16. Dienst M, Greis PE, Ellis BJ, et al. Effect of lateral meniscal allograft sizing on contact mechanics of the lateral tibial plateau: an experimental study in human cadaveric knee joints. Am J Sports Med, 2007, 35(1): 34-42.
17. 黄长征, 范伟杰, 陈志伟, 等. 成形联合修补术在盘状半月板损伤治疗中的应用. 中国骨伤, 2010, 23(6): 409-412.
18. 王友, 侯筱魁, 王以友, 等. 关节镜下半月板缝合技术的生物力学分析. 中华外科杂志, 1997, 35(2): 128.
19. 童学波, 俞辉国, 何国础. 关节镜下手术治疗儿童膝关节盘状软骨. 中华小儿外科杂志, 2003, 24(5): 443-445.
20. Boyd KT, Myers PT. Meniscus preservation: rationale, repair techniques and results. Knee, 2003, 10(1): 10-11.
21. Spahn G. Arthroseopic revisions in failed meniscal surgery. Int Orthop, 2003, 27(6): 378-381.
22. McGinty JB. Operative arthroscopy. New York: Raven, 1996: 288-291.
23. 鲁英, 谭维溢. 膝关节镜下半月板手术后康复训练的疗效. 中华物理医学与康复杂志, 2002, 24(9): 559-560.
24. 杨晓, 黄崇新, 王跃. 膝关节盘状半月板损伤的关节镜手术治疗. 西部医学, 2009, 21(2): 264.
25. Washington ER, Root L, Liener UC. Discoid lateral meniscus in children long-term follow-up after excision. J Bone Joint Surg (Am), 1995, 77(9): 1357-1361.
26. Jung KA, Lee SC, Hwang SH. ‘Suture-induced tear’ after human meniscal allograft transplantation. Knee, 2010, 17(1): 88-91.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ARTHROSCOPIC TREATMENT FOR LATERAL DISCOID MENISCUS INJURIES

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