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Year : 2017  |  Volume : 52  |  Issue : 3  |  Page : 169-174

Locked knee in children owing to torn discoid lateral meniscus: the role of arthroscopic management

1 Department of Orthopedic and Trauma Surgery, Faculty of Medicine, El Hadra University Hospital, Alexandria University, Alexandria, Egypt
2 Department of Orthopedic and Trauma Surgery, Faculty of Medicine, El Hadra University Hospital, Alexandria University, Alexandria; Department of Orthopedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University Hospital, Hiroshima, Egypt

Correspondence Address:
Mohamed M Abouheif
20 Omar Lutfy Street, Flat 25, Camp Sizar, Alexandria, 21525
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eoj.eoj_48_17

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Background Discoid meniscusis a relatively rare congenital anatomical abnormality in which the meniscus is discoid rather than semilunar in shape. A torn discoid lateral meniscus (DLM) can be a potential cause of mechanical symptoms in children; moreover, it is considered the commonest reason for arthroscopic interventions performed on children. Hypothesis Arthroscopic reshaping of the meniscus (meniscoplasty) by partial excision of the central part achieves good results in these patients. Patients and methods Twenty patients (20 knees) presenting with symptomatic torn DLM were included in the study. The age ranged from 3 to 11 years, with a mean of 7.2 years. Five of them were males and 15 were females. Seventeen of them had locked knee owing to displaced bucket handle tear of DLM. Two patients had complex tear of DLM, whereas only one patient had a longitudinal cleavage tear. All the cases experienced knee pain and swelling. Clinical evaluation of the patients was done according to the subjective and objective International Knee Documentation Committee (IKDC) 2000 forms, and Lysholm knee score. Moreover, radiological evaluation was performed using plain radiographs and MRI. All patients were managed by reshaping of the meniscus by arthroscopic central partial meniscectomy regardless of the tear type. The duration of follow-up ranged from 22 to 36 months, with a mean of 26.4 months. Results All the patients showed dramatic improvement postoperatively. The average postoperative subjective IKDC score was 76% as compared with 29.25% preoperatively. Postoperative IKDC objective grade was A in six (30%) cases and B in 13 (65%) cases at the end of follow-up, as compared with the preoperative grade assessment, which was D in six (30%) cases and C in 14 (70%) cases, with statistically highly significant results (P<0.001). Conclusion Torn DLM can be a potential cause of symptomatic knee pain and effusion in children and should not be overlooked. Arthroscopic central partial meniscectomy (meniscoplasty) can give good results in these cases.

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