To analyze the efficacy of arthroscopic meniscoplasty and suture fixation in treating discoid lateral meniscus (DLM) injuries, identify risk factors affecting outcomes, and construct a risk prediction model to provide a reference for improving the efficacy and prognosis of DLM injury treatment.

Inclusion criteria: MRI-confirmed DLM injury with symptoms; Watanabe type I or II; unilateral involvement and first-time arthroscopic surgery; complete clinical data without chronic knee diseases. Exclusion criteria: requirement for simultaneous bilateral surgery; history of knee surgery or other knee injuries; concurrent knee infection; surgical contraindications. A single-center, self-controlled cohort study was conducted. A total of 154 patients with DLM injuries who underwent arthroscopic meniscoplasty and suture fixation at the Department of Orthopedics, Renhe Hospital Affiliated to Three Gorges University between January 2020 and January 2024 were enrolled. Lysholm knee joint score scale (LKSS) was used to evaluate efficacy at six months after operation. The patients were divided into two groups based on efficacy: the excellent/good efficacy group (score ≥70) and the poor efficacy group (score <70). Univariation analysis and multivariate logistic regression analysis were performed to identify independent risk factors affecting efficacy, and a predictive model was constructed.

LKSS scores before surgeryand six monthsafter surgery were (67±7) and (90±7) respectively, with a statistically significant difference (t=29.701, P<0.001). The overall excellent efficacy rate at six months after operation was 81.8% (126/154). Univariation analysis and multivariate logistic regression analysis revealed that age [odds ratio (OR) = 1.189], disease duration (OR=1.054), and Outerbridge classification of cartilage injury (OR=1.251) were independent risk factors affecting efficacy ( all P<0.05). A predictive model was constructed based on these independent risk factors, with an area under the receiver operating characteristic (ROC) curve of 0.894 and a critical value of 90, indicating good discriminative ability.

Age, disease duration, and Outerbridge classification of cartilage injury are independent risk factors affecting the clinical efficacy of arthroscopic meniscoplasty and suture fixation for DLM injuries. These risk factors can be used for clinical prognosis risk prediction. High-risk patients (total score >90) with advanced age, prolonged disease duration, and severe cartilage injury may benefit from individualized interventions, treatments, and develop personalized treatment plans and rehabilitation programs.