Younger age is a risk factor for developing recurrent or postoperative osteochondritis dissecans after surgery for discoid lateral meniscus with/without preoperative osteochondritis dissecans

Abstract

AbstractPurposeTo evaluate the efficacy of surgical treatment of the discoid lateral meniscus with osteochondritis dissecans (OCD) through clinical and radiological evaluations, focusing on recurrent or postoperative OCD occurrence.MethodsThis retrospective study included patients with symptomatic discoid lateral meniscus with OCD (pre‐OCD group) and without OCD (non‐OCD group) who had undergone arthroscopic surgery with >5 years of follow‐up. Age, sex, Lysholm score, Tegner activity scale, surgical procedure, and recurrent or postoperative OCD lesions were compared. The association between patient variables and postoperative OCD was determined using multivariate logistic regression analysis.ResultsOf the 95 knees, 15 (15%) were in the pre‐OCD group. Healing was observed in 14/15 (93%) knees. Recurrent and postoperative OCDs were reported in 4/15 (28.5%) knees in the pre‐OCD and 7/80 (8.8%) knees in the non‐OCD groups at a mean of 3.2 ± 1.1 and 3.7 ± 1.2 years, respectively. Pre‐ and postoperative Tegner activity scale and Lysholm scores were higher in the pre‐OCD group but similar to those in the non‐OCD group. The incidence of recurrent OCD in the pre‐OCD group was significantly higher than that of postoperative OCD in the non‐OCD group. Younger patients (odds ratio, 0.49; p = 0.003) had an increased risk of experiencing recurrent or postoperative OCD in multivariate analysis. The optimal cutoff age for distinguishing recurrent or postoperative OCD was 9 years.ConclusionSurgical procedures for OCD lesions in the pre‐OCD group were successful. Multivariate analysis identified age as a risk factor for recurrent or postoperative OCD; therefore, conservative treatment is recommended for patients with discoid lateral meniscus before preadolescence to prevent postoperative OCD occurrence.Level of EvidenceLevel III.