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Predictive factors for developing osteochondritis dissecans after surgery for discoid lateral meniscus are younger age and shorter meniscal width

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to identify the predictive factors for postoperative osteochondritis dissecans (OCD) in juvenile and adolescent knees with discoid lateral meniscus (DLM).

Methods

In total, 242 patients with symptomatic DLM who underwent surgery were identified. Inclusion criteria were set as follows: (1) age ≤ 17 years with an open growth plate, (2) follow-up magnetic resonance imaging, and (3) absence of preoperative OCD. Consequently, 52 patients were retrospectively investigated. Average age during surgery, body mass index (BMI), and follow-up duration were 12 years [95% confidence interval (CI) 11–13], 19.2 kg/m2 (95% CI 18.4–20.1), and 27.3 months (95% CI 20.9–33.7), respectively. Age, sex, sports activities, BMI, symptomatic OCD in other joints, postoperative rehabilitation, preoperative shift of DLM by Ahn’s classification, surgical procedures (saucerization alone or with stabilization, and subtotal meniscectomy), and postoperative meniscal width were analyzed as possible predictive factors.

Results

Postoperatively, 42 patients without OCD and 10 with OCD were observed. In univariate analysis, younger age [odds ratio (OR) 1.5; p = 0.003], subtotal meniscectomy (OR 6.3; p = 0.027), and shorter meniscal width (OR 2.7; p = 0.005) were predictive factors for postoperative OCD. Multivariate analysis demonstrated that younger age (OR 1.6; p = 0.009) and shorter meniscal width (OR 1.5; p = 0.003) were predictive factors.

Conclusions

To prevent postoperative OCD after DLM surgeries, achieving stabilization with adequate meniscal width is necessary for juvenile knees.

Level of Evidence

III.

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Acknowledgements

The authors would like to thank all doctors in Niigata University and the affiliated hospitals: Drs. Watanabe K, Yamamoto N, Omori G, Shiozaki H, Segawa H, Matsueda M, Yamagiwa H, Higano Y, Ariumi A, Mera H, Murayama T, Fujii T, Koga H, Takagi S, Katsumi R, Muraoka O, Yamanaka K, Hokari S, Tomiyama Y, Hosono Y, Otani K, Soeno T, Hijikata H, Sasage Y, Maeda K, Someya K, and Koga Y. Moreover, we would like to thank Dr. Yonetani Y in Hoshigaoka Medical Center.

Funding

No external funding was used.

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan

    Tomoharu Mochizuki, Osamu Tanifuji & Naoto Endo

  2. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata, Japan

    Takashi Sato & Satoshi Watanabe

Authors
  1. Tomoharu Mochizuki
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  2. Osamu Tanifuji
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  3. Takashi Sato
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Correspondence to Tomoharu Mochizuki.

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Mochizuki, T., Tanifuji, O., Sato, T. et al. Predictive factors for developing osteochondritis dissecans after surgery for discoid lateral meniscus are younger age and shorter meniscal width. Knee Surg Sports Traumatol Arthrosc 29, 100–108 (2021). https://doi.org/10.1007/s00167-019-05750-6

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