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 degrees 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 post-operatively 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.
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机译：目的：评估关节镜中央侧凸半月板挤压术的临床和影像学结果。方法：二十一例接受了关节镜对侧半月板的集中治疗。在外侧半月板挤压（9例）或盘状半月板（12例）的情况下，将位于半月板中体和胶囊之间边缘的囊缝合到胫骨平台外侧边缘，并使用缝合锚钉将其集中减少或防止半月板挤压。临床结果包括临床检查结果，Lysholm评分，膝关节损伤和骨关节炎结果评分，以及有关患者满意度和运动表现水平的主观评分量表。影像学结果包括磁共振成像的半月板挤压宽度（MEW）和直立45度屈曲后前视图的侧关节间隙宽度。术前和术后2年均报告所有临床和影像学结果，而MEW则在1年时报告。结果与基线进行了比较。结果：与基线相比，术后2年的临床结果显着改善：Lysholm评分（97 v 69，P <.0001）以及除日常生活活动外（疼痛，89 v）的所有膝关节损伤和骨关节炎结果评分72，P = .0010;症状，91 v 74，P = .0002;日常生活活动，94 v 89，P = .091;运动和娱乐功能，79 v 42，P = .0028;生活质量，78 v 46，P = .0029）。患者满意度（84 v 22，P <.0001）和运动表现水平（82 v 15，P <.0001）也得到了改善。与挤压组相比，挤压组（1.0 mm v 5.0 mm，P <.0001）和盘状组（0.3 mm v 1.6 mm，P = .047）在1年时的MEW显着降低。挤压组的外侧关节间隙宽度在2年时增加（5.6 mm v 4.8 mm，P = .041），而盘状组的外侧关节间隙宽度保持不变（5.5 mm v 5.4 mm）。结论：关节镜在外侧半月板的集中改善了2年随访中半月板挤压以及盘状半月板的临床和影像学结果。证据级别：IV级，治疗病例系列。
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