Two-Year Outcomes After Arthroscopic Lateral Meniscus Centralization

Abstract

Purpose: To evaluate clinical and radiographic outcomes of arthroscopic centralization for lateral meniscal extrusion.

Methods: Twenty-one patients who underwent arthroscopic centralization of the lateral meniscus were included. In cases with an extruded lateral meniscus (9 patients) or discoid meniscus (12 patients), the capsule at the margin between the midbody of the lateral meniscus and the capsule was sutured to the lateral edge of the lateral tibial plateau and centralized using suture anchors to reduce or prevent meniscal extrusion. Clinical outcomes included clinical examination findings, Lysholm score, Knee Injury and Osteoarthritis Outcome Score, and subjective rating scales regarding patient satisfaction and sports performance level. Radiographic outcomes included meniscal extrusion width (MEW) on magnetic resonance imaging and lateral joint space width on a standing 45° flexion posteroanterior view. All clinical and radiographic outcomes were reported pre-operatively and at 2 years post-operatively, whereas MEW was reported at 1 year; outcomes were compared with baseline.

Results: Clinical outcomes were significantly improved at 2 years postoperatively compared with baseline: Lysholm score (97 v 69, P < .0001) and all subscores of the Knee Injury and Osteoarthritis Outcome Score except activities of daily living (pain, 89 v 72, P = .0010; symptoms, 91 v 74, P = .0002; activities of daily living, 94 v 89, P = .091; sport and recreational function, 79 v 42, P = .0028; and quality of life, 78 v 46, P = .0029). Patient satisfaction (84 v 22, P < .0001) and sports performance level (82 v 15, P < .0001) were also improved. At 1 year, MEW was significantly reduced compared with baseline for both the extrusion group (1.0 mm v 5.0 mm, P < .0001) and the discoid group (0.3 mm v 1.6 mm, P = .047). Lateral joint space width increased at 2 years in the extrusion group (5.6 mm v 4.8 mm, P = .041) and was maintained in the discoid group (5.5 mm v 5.4 mm).

Conclusions: Arthroscopic centralization of the lateral meniscus improved clinical and radiographic outcomes for meniscal extrusion as well as for discoid menisci at 2-year follow-up.

Level of evidence: Level IV, therapeutic case series.