Objective: To compare the mid-term effectiveness of arthroscopy versus conservative treatment on symptomatic discoid lateral meniscus (SDLM) in middle-aged and elderly patients.
Methods: The clinical data of 118 middle-aged and elderly patients (154 knees) with SDLM who received arthroscopy or conservative treatment between June 2014 and May 2016 were retrospectively analyzed, including 76 patients (96 knees) in the arthroscopy group (group A) and 42 patients (58 knees) in the conservative treatment group (group B). There was no significant difference in age, gender, and body mass index between the two groups (P>0.05). Compared with group B, the symptoms duration in group A was longer, the incidences of discoid lateral meniscus injury and mechanical symptoms were higher, and the visual analogue scale (VAS) score and Lysholm score before treatment were worse, with significant differences (P<0.05). VAS score and Lysholm score before and after treatment were recorded and compared.
Results: The patients in both groups were followed up 60-74 months, with an average of 66.3 months. The follow-up time of group A and group B was (65.9±3.5) months and (67.0±4.0) months respectively, with no significant difference (t=-1.615, P=0.109). At last follow-up, in either group A or group B, the VAS score and Lysholm score significantly improved when compared with those before treatment (P<0.05). The differences of VAS score and Lysholm score in group A before and after treatment were significantly better than those in group B (P<0.05).
Conclusion: Arthroscopy and conservative treatment have a satisfactory mid-term effectiveness on SDLM in middle-aged and elderly patients. However, the improvement of symptoms and function of arthroscopy was significantly better than that of conservative treatment. For middle-aged and elderly SDLM patients with invalidated conventional treatment for 6 months, severe clinical symptoms, long duration of symptoms, and combined with mechanical symptoms, arthroscopy should be given priority even if they are complicated with early osteoarthritis.
目的: 比较关节镜手术与保守治疗中老年膝关节症状性外侧盘状半月板（symptomatic discoid lateral meniscus，SDLM）的中期疗效。.
方法: 回顾分析2014年6月—2016年5月行关节镜手术或保守治疗的118例（154膝）中老年SDLM患者临床资料，其中76例（96膝）采用关节镜手术治疗（A组），42例（58膝）采用保守治疗（B组）。两组患者性别、年龄、身体质量指数比较差异均无统计学意义（P>0.05）；与B组相比，A组症状持续时间更长、外侧盘状半月板损伤及膝关节机械性绞锁症状发生率更高、治疗前疼痛视觉模拟评分（VAS）和Lysholm评分更差，差异均有统计学意义（P<0.05）。记录并比较两组治疗前后VAS评分及Lysholm膝关节功能评分。.
结果: 两组患者均获随访，随访时间60～74个月，平均66.3个月；其中A、B组随访时间分别为（65.9±3.5）、（67.0±4.0）个月，差异无统计学意义（t=–1.615，P=0.109）。末次随访时，两组VAS评分和Lysholm评分均较治疗前显著改善，差异有统计学意义（P<0.05）；A组VAS评分和Lysholm评分治疗前后差值均优于B组，差异亦有统计学意义（P<0.05）。.
结论: 对于中老年SDLM患者采用关节镜手术或保守治疗均可取得较满意中期疗效，但前者症状和功能改善程度明显优于后者。对于保守治疗6个月无效、临床症状较重、症状持续时间较长以及合并机械性绞锁症状者，即使合并早期骨关节炎，也应优先考虑关节镜手术。.
Keywords: Arthroscopy; conservative treatment; symptomatic discoid lateral meniscus; the middle-aged and elderly.