From Surgery to Sports Career: The Long-Term Fate of Athletes With Discoid Meniscus

Abstract

Objective:This study aimed to evaluate the long-term effectiveness of different surgical techniques for discoid meniscus in athletes. Design:This retrospective cohort study included 44 athletes (51 knees) who underwent arthroscopic surgery for symptomatic discoid meniscus between 1996 and 2019. Setting:The study was conducted at a tertiary-level sports medicine center. Patients:Athletes aged 15 to 35 years with symptomatic discoid meniscus confirmed by magnetic resonance imaging and requiring surgical treatment were included. Exclusion criteria were cartilage injuries (Outerbridge grades 3-4), concomitant ligament injuries requiring surgery, osteochondritis dissecans, and prior knee surgery. Interventions:Patients underwent arthroscopic partial, subtotal, or total meniscectomy, with or without meniscus repair. Main Outcome Measures:Functional outcomes were assessed using Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lysholm scores. Osteoarthritis progression was evaluated using the Kellgren-Lawrence classification. Return to sports time and total career duration were also recorded and compared between the surgical groups. Results:The mean follow-up was 13.5 +/- 6.2 years (range: 5-27 years). At the final follow-up, 72% of the meniscus-preserving group (partial meniscectomy and repair) had KL grade 0 osteoarthritis, whereas 38% of the subtotal/total meniscectomy group developed KL grades 3 to 4 osteoarthritis (P < 0.001). All groups showed significant postoperative functional improvements (P < 0.001), but career duration and return to play time were significantly longer in the meniscus-preserving group (P = 0.004, P < 0.001, respectively). Conclusions:Subtotal/total meniscectomy significantly accelerates osteoarthritis progression. Meniscus-preserving techniques provide better long-term outcomes.