Comparison between conservative and prophylactically concurrent meniscoplasty on the asymptomatic knee in children with unilaterally symptomatic bilateral discoid lateral meniscus operated on the symptomatic side: a retrospective study and literature review

Abstract

Abstract Background The literature compared conservative treatment and concurrent meniscoplasty for children with asymptomatic discoid lateral meniscus. This study aimed to compare the clinical outcomes between concurrent meniscoplasty and conservative management on the asymptomatic side in children with unilaterally symptomatic bilateral discoid lateral meniscus (DLM) operated on the symptomatic side. Methods In the literature review, three databases were searched up to September 2021. In the retrospective study, patients under 14 with unilaterally symptomatic bilateral DLM who underwent arthroscopic meniscoplasty were eligible. Patients were divided into two groups: children in group 1 underwent meniscoplasty on the symptomatic side, with the asymptomatic side conservatively treated. Children in group 2 underwent meniscoplasty on both the symptomatic and asymptomatic sides concurrently. Functional outcomes were evaluated using the Lysholm score and Ikeuchi score. Survival analysis of the occurrence of symptoms was applied by the Kaplan‒Meier model. Results In the literature review, 3 studies suggested for no treatment, 3 for observation only, 7 for non-surgical treatment, 1 considered it debating, and 1 recommended for prophylactic surgery. In the retrospective study, a total of 44 patients (34 female and 10 male) were eligible. For the average Lysholm scores, groups 1 and 2 of the previously asymptomatic side were 90.86 ± 8.25 and 92.67 ± 9.10, respectively. For the symptomatic side, the Lysholm scores were 91.38 ± 8.90 and 95.33 ± 7.18, respectively. The mean survival time was 9 years in group 1 and 5 years in group 2. The Kaplan‒Meier survival analysis of the occurrence of symptoms showed no statistically significant difference between the two groups (p = 0.121), and the terminal survival rates in the two groups were 86.2% and 80.0%, respectively. Conclusions No significant difference was reported on the asymptomatic side of conservative and surgical group in functional scores, while conservative group showed lower occurrence of symptoms and longer survival time. Trial registration The trial had been registered on the Chinese Clinical Trial Registry, with the number ChiCTR2000034577.