ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #1023

 

Risk Factors for Postoperative Osteochondritis Dissecans of the Lateral Femoral Condyle After Meniscal Surgery in Juvenile Patients with a Discoid Lateral Meniscus

Yusuke Hashimoto, MD, PhD, Osaka JAPAN
Shinya Yamasaki, MD, PhD, Osaka JAPAN
Junsei Takigami, MD, PhD, Osaka JAPAN
Tomohiro Tomihara, MD, Kobe, Hyogo JAPAN
Kazuya Nishino, MD, Osaka JAPAN
Hiroaki Nakamura, Prof., Osaka JAPAN

Osaka City University Graduate School of Medicine, Osaka, JAPAN

FDA Status Not Applicable

Summary

Reshaping surgery can reduce the postoperative OCD after the surgery with discoid lateral meniscus patients

Abstract

Background

Although arthroscopic total or subtotal meniscectomy for discoid lateral meniscus (DLM) lead to degenerative changes of the affected knee, the prevalence of postoperative osteochondritis dissecans (OCD) after DLM surgery in juvenile patients has not been well documented.Our purpose was to assess the prevalence of postoperative OCD and the risk factors associated with it after meniscal surgery (saucerization, saucerization with repair, or subtotal meniscectomy) for juvenile DLM.

Methods

Ninety patients (103 knees) with a mean age of 11.8 years who underwent arthroscopic meniscal surgery for DLM were enrolled an average of 3.9 years after surgery. Surgical procedure were performed with saucerization, saucerization with repair, or subtotal meniscectomy depending on the type of tear in DLM. Postoperative OCD lesions were identified radiographically and graded using the Brückl classification. Age, sex, preoperative OCD, Tegner activity scale (TAS), and surgical procedure type were compared between the two groups (postoperative OCD occurrence vs no occurrence).

Results

Postoperative OCD occurred in 12/103 (11.7%) knees after DLM surgery. The prevalence of postoperative OCD was significantly greater in those under the age of 10 compared with those 11 and older, and in males compared with females on univariate analyses. On multivariate analyses adjusted for age and sex, postoperative OCD occurred more commonly with subtotal meniscectomy than with reshaping surgery, and more when the TAS was 7 or over at the time of return to sports than with a TAS of 6 or under. The patients who had postoperative OCD underwent their surgery at an average age of 9.2 (range, 7 to 13) years. Postoperative OCD occurred in 1.5–5 years after surgery, at the average age of 12.2 (range, 11 to 15) years.

Conclusion

Postoperative OCD occurred in 12 of 103 knees after meniscal surgery for DLM. Although male sex and a younger age were predictive factors for postoperative OCD occurrence, reshaping surgery was associated with a decreased occurrence of postoperative OCD.