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Age is a Risk Factor for Postoperative Stiffness Following Surgical Treatment of Pediatric Discoid Lateral Meniscus:
Henry Baird1, Scott McKay2, Gregory Knell3
1University of Virginia, Charlottesville, VA.
Insights
Pediatric patients under 10 years old have a higher risk of postoperative stiffness after discoid lateral meniscus surgery. This finding highlights age as a key factor in surgical outcomes for this condition.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Meniscal pathology
Background:
- Discoid lateral meniscus is the most common cause of isolated meniscal issues in children.
- Limited understanding exists regarding complication variations across age groups for symptomatic discoid lateral meniscus surgery.
Purpose of the Study:
- To compare postoperative complication rates between pediatric age groups (<10 and ≥10 years) undergoing discoid lateral meniscus surgery.
- To determine if patient age is a risk factor for differing complication rates.
Main Methods:
- Retrospective comparative study (Level III) analyzing data from 2018-2022.
- Compared demographic, perioperative, and postoperative data between patients <10 and ≥10 years old.
- Utilized multivariable logistic regression to identify risk factors.
Main Results:
- 763 surgeries included: 160 (20.5%) in patients ≤10 years and 603 (79.5%) in patients ≥10 years.
- Overall complication rates were similar (11.9% vs. 11.9%).
- Patients ≤10 years had significantly higher rates of postoperative stiffness (11.3% vs. 3.3%), including extension loss (6.4% vs. 1.2%) and flexion loss (3.1% vs. 1.7%).
- Age ≤10 years was a risk factor for stiffness and extension loss (OR 2.67 and 3.09, respectively).
Conclusions:
- Younger pediatric patients (≤10 years) face an increased risk of postoperative stiffness after discoid lateral meniscus surgery.
- Age is a significant risk factor for developing postoperative stiffness and extension loss in this patient population.
Background:
Discoid lateral meniscus is the most common etiology for isolated meniscal pathology in the pediatric population. However, there remains a limited understanding of how complication rates vary among different age groups undergoing surgical management of a symptomatic discoid lateral meniscus. The aims of this study were to compare postoperative complication rates between age groups in pediatric patients undergoing surgical management of a symptomatic discoid lateral meniscus and assess whether patient age group is a risk factor for any complication rate that differed between the 2 age groups.
Methods:
Consecutive cases of discoid lateral meniscus surgeries from 2018 to 2022 were queried from the SCORE database. Demographic, perioperative, and postoperative complication data were collected and compared between patients <10 and ≥10 years old. A multivariable logistic regression was used to better understand those variables that demonstrated significant differences between age cohorts.
Results:
Seven hundred sixty-three discoid lateral meniscus surgeries were identified for inclusion in this study, with 160 (20.5%) aged 10 years or younger and 603 (79.5%) 10 years or older. Postoperative stiffness was the most common complication occurring in 5.0% of patients. Overall complication rates were no different between the 2 age groups (11.9% vs. 11.9%, P =1.000). Specific complication rates were also no different between the 2 age groups with the exception that patients 10 years or younger had higher rates of postoperative stiffness than patients 10 years or older (11.3% vs. 3.3%, P <0.001) including both extension loss (6.4% vs. 1.2%, P <0.001) and flexion loss (3.1% vs. 1.7%, P <0.001). In multivariable analysis, age 10 years or younger was identified as a risk factor for postoperative stiffness when controlling for confounding variables. Specifically, patients 10 years or younger had 2.67 (95% CI: 1.12-5.86) and 3.09 (95% CI: 1.11-8.62) times the odds of developing postoperative stiffness and extension loss, respectively, compared with patients 10 years or older.
Conclusion:
This study shows that age 10 years or younger is a risk factor for developing postoperative stiffness after undergoing surgical treatment of a symptomatic discoid lateral meniscus.
Level Of Evidence:
Level III-therapeutic, retrospective comparative study.
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