Background: While it is well established that obesity alters knee biomechanics, its long-term effects on outcomes following arthroscopic management of discoid lateral meniscus (DLM) remain poorly understood. Purpose: To investigate the relationship between body mass index (BMI) and outcomes following arthroscopic treatment of symptomatic children/adolescents with DLM. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted at a single institution to analyze pediatric and adolescent patients (age range 6-20 years) who underwent arthroscopic treatment for symptomatic DLM with a minimum 5-year follow-up. The cohort was divided into 2 groups based on patients’ BMI: <85th percentile (normal weight) and ≥85th percentile (overweight/obese). Patients underwent either isolated saucerization or saucerization and meniscus repair based on the presence of meniscal instability confirmed intraoperatively. Demographics, clinical presentation, arthroscopic findings and management, complications, rates of return to activity, and patient-reported outcomes (PROs) were collected. PRO measures were interpreted using established instrument-specific thresholds to define clinically acceptable or excellent outcomes. Wilcoxon rank-sum tests were used to compare postoperative PROs between normal-weight and overweight/obese patients. Results: Of the 36 patients included, 14 (38.89%) had a BMI <85th percentile and 22 (61.11%) had a BMI ≥85th percentile. No statistically significant differences were found between cohorts for demographics, clinical presentation, meniscus pathology, and surgical technique. PROs were considered acceptable to excellent in both groups after the 5-year follow-up. Comparison between normal-weight and overweight groups demonstrated no significant differences between PROs: Tegner Lysholm (95.00 vs 85.50; P = .974), Pediatric International Knee Documentation Committee (93.00 vs 90.83; P = .536), Knee injury and Osteoarthritis Outcome Score (KOOS)–Symptom (92.26 vs 82.14; P = .586), KOOS-Pain (93.30 vs 87.50; P = .824), KOOS–Activities of Daily Living (98.86 vs 97.73; P = .674), KOOS-Sport (96.43 vs 96.43; P = .755), and KOOS–Quality of Life (87.50 vs 79.16; P = .160). Overall reoperation rate was 8.3%, and 97.2% of patients returned to preinjury levels of activity. Conclusion: Overweight/obese pediatric and adolescent patients have comparable acceptable to excellent outcomes to patients who are normal weight at least 5 years following arthroscopic treatment for symptomatic DLM, demonstrating reliable 5-year outcomes regardless of BMI. Weight-related factors should not deter surgical management of overweight or obese patients with symptomatic DLM.
Ferreri et al. (Sun,) studied this question.