Decline in clinical scores at long-term follow-up of arthroscopically treated discoid lateral meniscus in children

Purpose: The purpose of this study was to examine the long-term clinical outcomes of arthroscopic partial meniscectomy for the treatment of discoid lateral meniscus in children. Methods: A previous study identified 34 consecutive patients that underwent arthroscopic meniscal saucerization by one of the two surgeons between 1997 and 2002. Patients were asked to complete several outcomes questionnaires and were given the opportunity to receive a knee exam performed by their treating surgeon. Results: Of the 34 eligible patients, 21 agreed to participate. Seventeen patients (19 knees) had greater than 2-year follow-up, with an average follow-up of 11.0 years (range 3.4–16.6 years). Average age at the time of surgery was 9.3 years. Average IKDC, Kujala, and Lysholm scores at follow-up were 82.8 ± 28.9, 86.6 ± 15.2, and 83.7 ± 18.6, respectively. In addition, median Marx and Tegner scores were 5 (range 0–14) and 6 (range 3–8), respectively. Stratifying the Lysholm scores revealed outcomes that were 45.4% “excellent”, 16.7% “good”, 25.0% “fair”, and 16.7% “poor”. In total, 36.8% (7 of 19) of knees underwent at least one subsequent surgical procedure. There were no significant associations between outcome scores and discoid type, meniscal stability, location of instability, or age at time of surgery. Conclusions: The results of the current study suggest that clinical outcome scores decline over time in patients treated arthroscopically for symptomatic discoid meniscus. Compared to our previous study with 2-year follow-up, there is an increased incidence of knee pain and mechanical/functional limitations. The overall modest, long-term results of this study illustrate the need for improved operative treatments for symptomatic discoid meniscus in children to prevent progressive, long-term clinical decline in these patients.