Journal of Pediatric Orthopaedics - 2026-05-04 - Journal Article
Age is a Risk Factor for Postoperative Stiffness Following Surgical Treatment of Pediatric Discoid Lateral Meniscus: A Report From the SCORE Multicenter Database.
Baird H, McKay S, Knell G, Wilson P, Frank J, Mansour A, Shea K, Ellis H, Members of the SCORE Quality Improvement Registry
Topics
Key Takeaway
Children ≤10 years undergoing discoid lateral meniscus surgery have 2.67 times the odds of postoperative stiffness compared to those >10 years (95% CI: 1.12–5.86).
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Summary
This SCORE multicenter database study compared postoperative complication rates between pediatric discoid lateral meniscus patients aged ≤10 versus >10 years across 763 consecutive cases from 2018–2022. Overall complication rates were identical between groups (11.9% vs. 11.9%), but younger patients had significantly higher rates of postoperative stiffness (11.3% vs. 3.3%, P<0.001), including both extension loss (6.4% vs. 1.2%) and flexion loss (3.1% vs. 1.7%). Multivariable logistic regression confirmed age ≤10 as an independent risk factor for stiffness (OR 2.67) and extension loss specifically (OR 3.09).
Key Limitation
Absence of standardized rehabilitation data across SCORE sites prevents determining whether the stiffness differential reflects patient biology, surgical technique differences (extent of saucerization, concomitant repair), or postoperative immobilization practices.
Original Abstract
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.