全球盘状半月板管理差异：儿科运动医学研究亚太分会与手术队列结局登记经验注册中心的比较研究
简介
一项2024年1—7月的横断面问卷比较了亚太地区（54名，应答率100%）与北美（26名）儿童及运动骨科医生对盘状半月板的管理策略：两地均以saucerization（碟形化）为主（94.3% vs 93.7%），但亚太医生报告半月板修复更常见（71.4% vs 54.6%），尤其在实质内撕裂（82.5% vs 24.3%）和边缘不稳（65.8% vs 8.…
英文摘要
PURPOSE: To compare diagnostic emphasis and surgical management strategies for discoid meniscus (DM) between Asia-Pacific surgeons participating in the Pediatric Research in Sports Medicine collaborative and North American surgeons within the Surgical Cohort Outcome Registry Experience registry. METHODS: Between January and July 2024, a cross-sectional survey was conducted among fellowship-trained pediatric and sports orthopaedic surgeons in the Pediatric Research in Sports Medicine Asia-Pacific collaborative. Surgeons with active clinical experience managing DM were invited to participate, and all 54 completed the survey (response rate 100%). These responses were compared with data from 26 North American surgeons participating in the Surgical Cohort Outcome Registry Experience. Variables, including meniscal morphology, tear patterns, instability location, and surgical management strategies, were harmonized between datasets and compared using χ 2 or Fisher's exact tests. RESULTS: A total of 54 Asia-Pacific surgeons and 26 North American surgeons were included. Complete discoid morphology was more commonly reported in North America (57.6% vs 49.0%), whereas incomplete morphology predominated in Asia-Pacific (51.4% vs 42.4%). Horizontal or cleavage tears were more frequent in Asia-Pacific (45.6% vs 20.7%, P = .036). Saucerization was the predominant treatment in both regions (94.3% vs 93.7%). Meniscal repair was reported more frequently in Asia-Pacific (71.4% vs 54.6%), particularly for intrasubstance tears (82.5% vs 24.3%) and rim instability (65.8% vs 8.8%). Among patients aged ≥14 years, repair rates remained higher in Asia-Pacific (74.8% vs 44.1%, P = .012). CONCLUSIONS: Saucerization was the predominant surgical treatment for DM in both Asia-Pacific and North American cohorts. Regional differences were observed in tear characterization, instability localization, and repair thresholds. These findings show variation in clinical practice patterns despite a shared emphasis on meniscal preservation. CLINICAL RELEVANCE: Understanding regional variation in DM diagnosis and management may help improve the recognition of tear patterns and instability across populations. Although saucerization remains the cornerstone of treatment globally, differences in tear characterization and repair thresholds highlight the need for standardized classification systems and internationally aligned treatment strategies to optimize meniscal preservation.