Effect of arthroscopic resection for discoid lateral meniscus on the axial alignment of the lower limb

Int Orthop. 2018 Aug;42(8):1897-1903. doi: 10.1007/s00264-018-3944-5. Epub 2018 May 16.

Abstract

Purpose: This study was designed to investigate the changes in the lower limb axial alignment and knee joint function after arthroscopic resection of discoid lateral menisci.

Methods: Pre-operative and post-operative full-length weight-bearing radiographs of the lower limb were obtained from 60 patients with discoid lateral menisci from August 2015 to August 2016. Twenty-four patients were treated with meniscectomy and 36 cases were treated with meniscoplasty. The axial alignment of the lower limb was measured, and changes in the lower limb axial alignment before and after surgery were analyzed. The effects of differing degrees of meniscal resection on the lower limb axial alignment were compared and analyzed. Knee joint function on the affected side was scored using the Lysholm knee scoring, Tegner activity, and International Knee Documentation Committee (IKDC) subjective scales before surgery and one, six and 12 months after surgery.

Results: There were apparent changes in the lower limb axial alignment after surgery (p < 0.01). The changes were more conspicuous after a total meniscectomy than a meniscoplasty but were insignificant (p > 0.05). Intragroup comparisons of the Lysholm knee, IKDC, and Tegner scores before and after surgery revealed significant differences (p < 001). However, the differences were not significant between the two surgical approaches (p > 0.05).

Conclusion: For those with considerable genu varum or genu valgum after surgery, individualized therapy should be developed to correct the lower limb axial alignment and to prevent articular cartilage degeneration. Arthroscopic resection of a discoid lateral meniscus greatly improves knee joint function.

Keywords: Arthroscopy; Axial alignment of the lower limb; Biomechanics; Discoid meniscus.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroscopy*
  • Bone Malalignment / diagnostic imaging
  • Bone Malalignment / etiology
  • Bone Malalignment / surgery
  • Cartilage, Articular / diagnostic imaging
  • Cartilage, Articular / surgery
  • Child
  • Female
  • Genu Valgum / diagnostic imaging
  • Genu Valgum / etiology
  • Genu Valgum / surgery
  • Genu Varum / diagnostic imaging
  • Genu Varum / etiology
  • Genu Varum / surgery
  • Humans
  • Knee Joint / physiopathology
  • Knee Joint / surgery
  • Lower Extremity / diagnostic imaging
  • Lower Extremity / physiopathology
  • Lower Extremity / surgery
  • Male
  • Menisci, Tibial / diagnostic imaging
  • Menisci, Tibial / pathology
  • Menisci, Tibial / surgery*
  • Middle Aged
  • Range of Motion, Articular
  • Young Adult