Residual Midbody Meniscal Widths >13 mm Immediately After Surgery Decreased Faster and Had Greater Complication Rates in Discoid Lateral Menisci Treated With Saucerization and Repair
Yusuke Hashimoto, Nozomi Aibara, Shinya Yamasaki, Yohei Nishida, Tomihara Tomohiro, Hidetomi TeraiPurpose
To estimate the adequate residual midbody meniscal width immediately after surgery saucerization with repair for discoid lateral meniscus (DLM) and at subsequent follow‐up, and to evaluate the complication rate.
Methods
A retrospective analysis was conducted on complete DLM cases that underwent saucerization with repair from August 2017 to January 2023, with a minimum follow‐up of 2 years. Knees were classified into 3 groups based on midbody meniscal width immediately after surgery: large (>13 mm), normal (9 to ≤13 mm), and small (<9 mm). Changes in residual meniscal width over time and complications such as retear, revision surgery, and postoperative osteochondritis dissecans were assessed. The minimum clinically important difference of the Lysholm score was calculated. Demographic data and meniscal width immediately after surgery were analyzed for associations with greater than a 50% reduction in residual midbody width from 0 to 24 months using logistic regression analyses.
Results
Seventy‐seven knees of 72 patients were reviewed in this study. The minimum clinically important difference achievement rate was 98.7%, with no significant difference among the 3 groups. The complication rate in the large group was significantly higher than in the normal group ( P = .026). On multivariate analysis, greater midbody meniscal width at 0 months (odds ratio, 1.38; P = .006) was identified as a risk factor for >50% reduction in residual midbody width, with a cutoff value of 11.5 mm.
Conclusions
Although clinical outcomes showed favorable minimum clinically important difference achievement regardless of meniscus size, a residual midbody meniscal width >13 mm immediately after surgery decreased faster than smaller widths and had greater complication rate in DLM treated with saucerization and repair.
Level of Evidence
Level IV, retrospective case series.