Relationship Between Age and Pathology With Treatment of Pediatric and Adolescent Discoid Lateral Meniscus: A Report From the SCORE Multicenter Database.

Autor:	Silverstein RS; Baylor College of Medicine, Houston, Texas, USA; Texas Children's Hospital, Houston, Texas, USA., McKay SD; Baylor College of Medicine, Houston, Texas, USA; Texas Children's Hospital, Houston, Texas, USA., Coello P; Baylor College of Medicine, Houston, Texas, USA., Pupa L; Baylor College of Medicine, Houston, Texas, USA., Latz K; Department of Orthopedics-Sports Medicine, Children's Mercy, Kansas City, Missouri, USA., Craig Kemper W; University of Texas Southwestern Medical Center, Dallas, Texas, USA., Adsit E; Scottish Rite for Children, Dallas, Texas, USA., Wilson PL; University of Texas Southwestern Medical Center, Dallas, Texas, USA; Scottish Rite for Children, Dallas, Texas, USA., Albright J; Department of Orthopedics, Children's Hospital Colorado, Aurora, Colorado, USA., Algan S; Department of Orthopedic Surgery, Oklahoma Children's Hospital, Oklahoma City, Oklahoma, USA., Beck J, Bowen RE; Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA; Orthopedic Institute for Children's Center for Sports Medicine, Los Angeles, California, USA., Brey J; Department of Orthopedics, Norton Children's Orthopedics of Louisville, Louisville, Kentucky, USA., Marc Cardelia J; Department of Orthopedics and Sports Medicine, Children's Hospital of the King's Daughters, Norfolk, Virginia, USA., Clark C; OrthoCarolina Pediatric Orthopaedic Center, Charlotte, North Carolina, USA)., Crepeau A; Elite Sports Medicine at Connecticut Children's, Hartford, Connecticut, USA; Division of Sports Medicine, Department of Orthopedics, UConn Health, Farmington, Connecticut, USA., Edmonds E; Division of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA., Ellington M; Department of Orthopedics, Central Texas Pediatric Orthopedics, Austin, Texas, USA; Dell Medical School, University of Texas at Austin, Austin, Texas, USA., Fabricant PD; Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA; Weill Cornell Medical College, New York, New York., Frank JS; Division of Pediatric Orthopaedics and Spinal Deformities, Joe DiMaggio Children's Hospital, Hollywood, Florida, USA., Ganley TJ; Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Green DW; Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA., Gupta A; Division of Pediatric Orthopaedics and Spinal Deformities, Joe DiMaggio Children's Hospital, Hollywood, Florida, USA., Heyworth B; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA., Mansour A; Department of Orthopedic Surgery, UTHealth Houston, McGovern Medical School, Houston, Texas, USA., Mayer S; Department of Orthopedics, Children's Hospital Colorado, Aurora, Colorado, USA., Milewski MD; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA., Niu E; Department of Orthopedic Surgery and Sports Medicine, Children's National Medical Center, Washington, DC, USA., Pacicca DM; Department of Orthopedics-Sports Medicine, Children's Mercy, Kansas City, Missouri, USA., Parikh SN; Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA., Rhodes J; Department of Orthopedics, Children's Hospital Colorado, Aurora, Colorado, USA., Saper M, Schmale GA; Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, Seattle, Washington, USA., Schmitz M; San Antonio Military Medical Center, San Antonio, Texas, USA., Shea K; Department of Orthopaedics, Stanford University School of Medicine, Stanford, California, USA., Storer S; Division of Pediatric Orthopaedics and Spinal Deformities, Joe DiMaggio Children's Hospital, Hollywood, Florida, USA., Ellis HB Jr; University of Texas Southwestern Medical Center, Dallas, Texas, USA; Scottish Rite for Children, Dallas, Texas, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2023 Nov; Vol. 51 (13), pp. 3493-3501. Date of Electronic Publication: 2023 Oct 29.
DOI:	10.1177/03635465231206173
Abstrakt:	Background: Surgical treatment options of discoid lateral meniscus in pediatric patients consist of saucerization with or without meniscal repair, meniscocapular stabilization, and, less often, subtotal meniscectomy. Purpose: To describe a large, prospectively collected multicenter cohort of discoid menisci undergoing surgical intervention, and further investigate corresponding treatment of discoid menisci. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter quality improvement registry (16 institutions, 26 surgeons), Sports Cohort Outcomes Registry, was queried. Patient characteristics, discoid type, presence and type of intrasubstance meniscal tear, peripheral rim instability, repair technique, and partial meniscectomy/debridement beyond saucerization were reviewed. Discoid meniscus characteristics were compared between age groups (<14 and >14 years old), based on receiver operating characteristic curve, and discoid morphology (complete and incomplete). Results: In total, 274 patients were identified (mean age, 12.4 years; range, 3-18 years), of whom 55.6% had complete discoid. Meniscal repairs were performed in 55.1% of patients. Overall, 48.5% of patients had rim instability and 36.8% had >1 location of peripheral rim instability. Of the patients, 21.5% underwent meniscal debridement beyond saucerization, with 8.4% undergoing a subtotal meniscectomy. Patients <14 years of age were more likely to have a complete discoid meniscus ( P < .001), peripheral rim instability ( P = .005), and longitudinal tears ( P = .015) and require a meniscal repair ( P < .001). Patients ≥14 years of age were more likely to have a radial/oblique tear ( P = .015) and require additional debridement beyond the physiologic rim ( P = .003). Overall, 70% of patients <14 years of age were found to have a complete discoid meniscus necessitating saucerization, and >50% in this young age group required peripheral stabilization/repair. Conclusion: To preserve physiological "normal" meniscus, a repair may be indicated in >50% of patients <14 years of age but occurred in <50% of those >14 years. Additional resection beyond the physiological rim may be needed in 15% of younger patients and 30% of those aged >14 years. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: See the Appendix (available in the online version of this article). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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