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      Simultaneous Meniscal Repair and Temporary Guided Growth Using a Tension Band Plate to Correct Alignment in Pediatric Discoid Lateral Meniscus Patients With Valgus Knee

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      Author(s): , M.D., Ph.D. a , ∗ , , M.D., Ph.D. b , , M.D., Ph.D. b , , M.D. c , , M.D. c , , M.D., Ph.D. b , , M.D. c
      Publication date (Electronic):
      Journal: Arthroscopy Techniques
      Publisher: Elsevier

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          Abstract

          Meniscal stabilization with saucerization has recently been recommended for discoid lateral meniscus (DLM) to preserve the meniscus shape and prevent the progression of osteoarthritis. However, axial alignment of the lower limb causes a significant valgus change after arthroscopic partial meniscectomy and can lead to progressive lateral osteoarthritic changes. Thus, valgus knees in patients with DLM are a suspected predictive factor for poor outcomes after DLM surgery. Valgus malalignment in pediatric patients can be corrected by temporarily tethering one side of the open physis using implant-mediated guided growth to generate differential growth in the coronal plane. This Technical Note describes simultaneous arthroscopic meniscal surgery and temporary hemiepiphysiodesis to treat DLM with valgus deformities to reduce the risk of future chondral damage to the lateral knee compartment.

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          Valgus malalignment is a risk factor for lateral knee osteoarthritis incidence and progression: findings from the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative.

          David T Felson, Jingbo Niu, K Douglas Gross … (2013)
          To study the effect of valgus malalignment on knee osteoarthritis (OA) incidence and progression. We measured the mechanical axis from long limb radiographs from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI) to define limbs with valgus malalignment (mechanical axis of ≥1.1° valgus) and examined the effect of valgus alignment versus neutral alignment (neither varus nor valgus) on OA structural outcomes. Posteroanterior radiographs and knee magnetic resonance (MR) images were obtained at the time of the long limb radiograph and at followup examinations. Lateral progression was defined as an increase in joint space narrowing (on a semiquantitative scale) in knees with OA, and incidence was defined as new lateral narrowing in knees without radiographic OA. We defined lateral cartilage damage and progressive meniscal damage as increases in cartilage or meniscus scores at followup on the Whole-Organ Magnetic Resonance Imaging Score scale (for the MOST) or the Boston Leeds Osteoarthritis Knee Score scale (for the OAI). We used logistic regression with adjustment for age, sex, body mass index, and Kellgren/Lawrence grade, as well as generalized estimating equations, to evaluate the effect of valgus alignment versus neutral alignment on disease outcomes. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs). We studied 5,053 knees (881 valgus) of subjects in the MOST cohort and 5,953 knees (1,358 valgus) of subjects in the OAI cohort. In both studies, all strata of valgus malalignment, including 1.1° to 3° valgus, were associated with an increased risk of lateral disease progression. In knees without radiographic OA, valgus alignment >3° was associated with incidence (e.g., in the MOST, adjusted OR 2.5 [95% CI 1.0-5.9]). Valgus alignment >3° was also associated with cartilage damage on MR imaging in knees without OA (e.g., in the OAI, adjusted OR 5.9 [95% CI 1.1-30.3]).We found a strong relationship of valgus malalignment with progressive lateral meniscal damage. Valgus malalignment increases the risk of knee OA radiographic progression and incidence as well as the risk of lateral cartilage damage. It may cause these effects, in part, by increasing the risk of meniscal damage. Copyright © 2013 by the American College of Rheumatology.
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            A preliminary modeling investigation into the safe correction zone for high tibial osteotomy

            Andrew J Price, Jennifer LB Martay, Antony JR Palmer … (2018)
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              Systematic Review of the Long-term Surgical Outcomes of Discoid Lateral Meniscus

              O-Sung Lee, Je Ho Lee, Seow Hui Teo … (2017)
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                Author and article information

                Contributors
                Yusuke Hashimoto
                Journal
                Journal ID (nlm-ta): Arthrosc Tech
                Journal ID (iso-abbrev): Arthrosc Tech
                Title: Arthroscopy Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2212-6287
                Publication date PMC-release: 30 May 2024
                Publication date Collection: September 2024
                Publication date (Electronic): 30 May 2024
                Volume: 13
                Issue: 9
                Electronic Location Identifier: 103039
                Affiliations
                [a ]Department of Health and Sport Management, Osaka University of Health and Sports Science, Osaka, Japan
                [b ]Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
                [c ]Department of Orthopaedic Surgery, Shimada Hospital, Osaka, Japan
                Author notes
                [∗ ]Address correspondence to Yusuke Hashimoto, M.D., Ph.D., Department of Health and Sport Management, Osaka University of Health and Sports Science, 1-1, Asashirodai, Kumatori-cho, Sennan-gun, Osaka, 590-0496, Japan. hussyyomu@ 123456omu.ac.jp
                Article
                Publisher Item ID: S2212-6287(24)00148-8 Publisher ID: 103039
                DOI: 10.1016/j.eats.2024.103039
                PMC ID: 11411329
                PubMed ID: 39308586
                SO-VID: 9de2ba51-755b-4d52-8619-5c23da2b7b43
                Copyright © © 2024 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 25 January 2024
                Date accepted : 2 April 2024
                Categories
                Subject: Technical Note
                Subject: Knee

                Data availability:

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