Objective: This study aimed to evaluate the long-term effectiveness of different surgical techniques for discoid meniscus in athletes. Design: This retrospective cohort study included 44 athletes (51 knees) who underwent arthroscopic surgery for symptomatic discoid meniscus between 1996 and 2019. Setting: The study was conducted at a tertiary-level sports medicine center. Patients: Athletes aged 15 to 35 years with symptomatic discoid meniscus confirmed by magnetic resonance imaging and requiring surgical treatment were included. Exclusion criteria were cartilage injuries (Outerbridge grades 3–4), concomitant ligament injuries requiring surgery, osteochondritis dissecans, and prior knee surgery. Interventions: Patients underwent arthroscopic partial, subtotal, or total meniscectomy, with or without meniscus repair. Main Outcome Measures: Functional outcomes were assessed using Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lysholm scores. Osteoarthritis progression was evaluated using the Kellgren–Lawrence classification. Return to sports time and total career duration were also recorded and compared between the surgical groups. Results: The mean follow-up was 13.5 ± 6.2 years (range: 5-27 years). At the final follow-up, 72% of the meniscus-preserving group (partial meniscectomy and repair) had KL grade 0 osteoarthritis, whereas 38% of the subtotal/total meniscectomy group developed KL grades 3 to 4 osteoarthritis ( P < 0.001). All groups showed significant postoperative functional improvements ( P < 0.001), but career duration and return to play time were significantly longer in the meniscus-preserving group ( P = 0.004, P < 0.001, respectively). Conclusions: Subtotal/total meniscectomy significantly accelerates osteoarthritis progression. Meniscus-preserving techniques provide better long-term outcomes.

Background: Biological graft maturation after anterior cruciate ligament (ACL) reconstruction is a prolonged and heterogeneous process that may not directly correlate with clinical recovery. Magnetic resonance imaging (MRI)–based signal intensity ratio (SIR) is widely used as an indirect marker of graft remodeling and early maturation. However, comparative data regarding MRI-based graft maturation between quadriceps tendon (QT) and hamstring tendon (HT) autografts remain limited. Purpose: To compare graft maturation between all–soft tissue QT autografts and HT autografts using quantitative MRI-based SIR at 6 and 12 months after primary all-inside ACL reconstruction in athletes. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 76 athletes undergoing primary all-inside ACL reconstruction were prospectively enrolled. QT autografts were used in 39 patients and HT autografts in 37 patients. All patients followed a standardized postoperative rehabilitation protocol and underwent 3.0-T MRI evaluation at 6 and 12 months. Graft maturation was assessed using SIR measurements obtained from standardized regions of interest along the intra-articular graft, with the posterior cruciate ligament used as reference. Interobserver reliability was evaluated using intraclass correlation coefficients (ICCs). Results: Baseline patient characteristics and associated surgical procedures did not differ between groups (all P > .05). At both 6 and 12 months postoperatively, the mean SIR values were similar between QT and HT autografts ( P > .05). Within-group analysis showed a significant decrease in SIR values from 6 to 12 months in both groups ( P < .05), indicating progressive graft maturation. The magnitude of SIR change did not differ between groups ( P > .05). Interobserver reliability was excellent, with ICC(2,1) values of 0.98 at 6 months and 0.98 at 12 months. Conclusion: Quantitative MRI-based assessment using SIR demonstrated no significant difference in graft maturation between all–soft tissue QT and HT autografts at 6 and 12 months after primary all-inside ACL reconstruction. Both graft types showed comparable MRI-based maturation profiles during the early postoperative period, supporting QT autografts as a reliable alternative to HT autografts in athletic populations. Registration: NCT06617559 (ClinicalTrials.gov identifier).