Discoid lateral meniscus: diagnosis and results of arthroscopic treatment (original) (raw)
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Symptomatic discoid lateral meniscus managed by meniscoplasty -A case series
IP innovative publication pvt. ltd, 2019
Discoid meniscus are a rare entity and this short study was done to evaluate the results of meniscoplasty in symptomatic knees having discoid lateral meniscus. Eight patients all males in age group of 15 to 25 years presented to us with symptoms of pain, locking and restricted movements at the knee. After investigations the cause was found to be torn discoid lateral meniscus in all the 8 patients. All the patients were managed by arthroscopic meniscoplasty and were evaluated by Lysholm grading on followup. There were no complications in any patient and the symptoms of all patients were relieved. At two years of followed up there were no radiological signs of osteoarthritis. With this study we observed that meniscoplasty provides are good treatment option with excellent results in cases of symptomatic knees with discoid lateral meniscus.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2007
Purpose: The purpose of this study was to review the operative results of children and young adults treated arthroscopically for symptomatic discoid lateral menisci. Methods: The medical records and radiographic studies of 27 consecutive patients (30 knees) who underwent arthroscopic treatment for symptomatic discoid meniscus between 1998 and 2002 were reviewed. Results: The mean patient age was 10.1 years (range, 3 to 20 years), with 19 female and 8 male patients. The mean duration of symptoms before surgery was 13.9 months, with 28 knees (93%) having pain and 20 knees (67%) having mechanical symptoms. All patients were treated arthroscopically. Arthroscopic saucerization was successful in 28 of 30 knees. In 2 cases with large complex tears meniscal salvage was not possible and a complete arthroscopic meniscectomy was performed. Operative classification of the menisci revealed 22 complete (4 Wrisberg type) and 8 incomplete discoid menisci, with meniscal tears being present in 23 of 30 (77%). Meniscal instability was noted in 77% of knees (23 of 30), with anterior horn instability in 53% (n ϭ 16), posterior instability in 16% (n ϭ 5), and combined anterior and posterior instability in 6% (n ϭ 2). All cases of anterior horn instability were treated with an outside-in arthroscopic repair technique, whereas all cases of posterior horn instability were treated with meniscal repair via an inside-out arthroscopic technique. Twenty-one patients (23 knees) had full follow-up of greater than 1 year. For these 21 patients, the mean length of follow-up was 37.4 months (range, 12 to 77 months), and at final follow-up, all patients exhibited full knee flexion beyond 135°. Three patients reported residual knee pain, and four reported intermittent mechanical symptoms. At final follow-up, 2 patients felt that their activity level remained partially limited. Conclusions: Our results show the short-term efficacy of arthroscopic saucerization and repair to the capsule in selected cases of symptomatic discoid menisci. On the basis of this experience and other recent reports documenting a high rate of anterior horn instability, an arthroscopic classification system for discoid lateral menisci is proposed. Menisci are classified as complete or incomplete discoid and are then subclassified based on the presence of instability as a result of deficient capsular attachment and, finally, based on the location of the absent capsular attachment. Level of Evidence: Level IV, therapeutic case series.
Management of discoid lateral meniscus tears: Observations in 34 knees
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 2003
Purpose: The goal of this study was to evaluate arthroscopic partial resection of discoid lateral meniscus tears with an emphasis on radiographic evidence of degenerative changes after this procedure. Type of Study: Retrospective clinical study. Methods: Of 41 patients with an arthroscopic diagnosis of discoid meniscus over an 8-year period, 34 symptomatic lateral discoid meniscus tears in 33 patients were analyzed at an average follow-up of 5.6 years. The average age at operation was 19.8 years and most patients had vague and intermittent symptoms that caused delay in clinical diagnosis. Results: Eight patients were lost to follow-up and were excluded from the study. Magnetic resonance imaging, performed in 12 cases, and arthroscopy in all of these patients provided the precise diagnosis. All of the knees with symptomatic torn discoid menisci underwent arthroscopic partial meniscectomy. Only 1 Watanabe Wrisberg ligament type of discoid meniscus with posterior instability was totally meniscected. Based on Ikeuchi's grading, 39% of the knees had an excellent result, 46% had a good result, and 15% had a fair result; none of the results was poor. Conclusions: At an average 5-year follow-up, partial meniscectomy in patients with a Watanabe complete or incomplete discoid meniscus showed 85% good or excellent clinical results. However, a significant percentage of patients show femoral condyle flattening on radiography.
Discoid Lateral Meniscus Incidence During Knee Arthroscopy
Serbian Journal of Experimental and Clinical Research, 2015
Discoid meniscus is a morphological anomaly of the lateral meniscus that appears in 1–5% of meniscectomies. A precise diagnosis remains difficult to make, and many dilemmas hinder effective treatment.To evaluate the incidence of discoid meniscus in patients who underwent knee arthroscopy, as well as the discoid meniscus type, follow-up problems, combined knee lesions, and postoperative results.This retrospective study included 1357 patients who received knee arthroscopy during the period between January 2007 and December 2013. We analysed the discoid meniscus incidence, sex distribution, type distribution (Monllau classification), noted preoperative symptomatology, rupture incidence and type (O’Connor classification), anomaly presence and other intra-articular lesion correlations. The IKDC score was used to evaluate the operative treatment results.The DLM incidence was 1.03%. The most common type of discoid meniscus was complete 5 (35.71 %). The dominant symptom was pain, which was ...
Purpose The purpose of this retrospective study was to evaluate the results and prognostic factors affecting the outcome of arthroscopic saucerization for discoid lateral meniscus (DLM). Methods Forty-eight patients who underwent arthroscopic saucerization for DLM between January 2009 and January 2012 in two hospitals were included. There were 21 (43.8 %) male and 27 (56.3 %) female patients with a mean age of 36.02 ± 14.5 (range 9–65) years at the time of operation. According to Watanabe classification, 33 (68.7 %) patients had type II (incomplete) discoid meniscus and 15 (31.3 %) had type I (complete) discoid meniscus. Of the 48 patients, 26 (54.2 %) had an associated lateral meniscal tear. Seventeen patients (35.4 %) had accompanying ligamentous, chondral and/or medial meniscal lesions. The symptoms were present for a mean of 8.04 ± 4.48 (range 1–24) months before the operation. All patients were followed up with a mean of 27.7 ± 10.7 (range 12–47) months using Lysholm knee score. We analyzed the relationship between the outcome variable (Lysholm knee score at the final follow-up) and the predictor variables (age, gender, type of DLM, presence of meniscal tear, duration of symptoms, follow-up and accompanying intra-articular lesions). Results The mean preoperative Lysholm knee score was 46.6 ± 10.2 points and increased to 85.08 ± 13.45 points at the final follow-up (p = 0.0001). Twenty (41.7 %) excellent, seven (14.6 %) good, nineteen (39.6 %) fair and two (4.2 %) poor results have obtained. No complications were observed in any patient. Regression analysis showed that age was the only predictor of the Lysholm score at the final follow-up (R2 = 0.545, p = 0.0001). The linear regression equation was (Lysholm score at final followup) = 106.1 - [0.58 9 (age of patient)]. Conclusions This study demonstrated that arthroscopic saucerization is an effective and safe treatment modality for DLM. Furthermore, age of the patient was shown to be the most important prognostic factor over the final clinical outcome. An excellent or a good result can be expected when the patient is young at the time of operation. Level of evidence IV.
La Clinica terapeutica, 2013
To evaluate clinical and radiographic mid-term outcomes and improvement in quality of life in pediatric patients affected by LDM and who underwent partial or total/subtotal meniscectomy. 28 patients (12 M, 16 F), mean age 8.3 years old (range: 6-13) affected by LDM with symptoms and/or meniscal tears, mean follow up: 2 years and 4 months (range: 24-52 months). Symptoms included: pain, swelling, articular block, limitation to knee extention, meniscal instability and formation of meniscal cysts. 23 patients treated with partial meniscectomy, 5 by total/subtotal meniscectomy. All of them have been clinically evaluated using the Ikeuchi scale and the POSNA questionnaire; for radiological evaluation we used the Tapper-Hoover grading scale. Ikeuchi: In 23 patients underwent partial meniscectomy: 21 excellent and 2 good; in 5 patients underwent total/subtotal meniscectomy: 1 excellent, 2 good and 2 average. POSNA presurgical mean score: partial meniscectomy: 70 (range 66.8-73.6), total/sub...
Symptomatic Discoid Meniscus: A Case Series
The Hip and Knee Journal
Background: Discoid meniscus is a rare entity of knee pathology. The discoid meniscus can be encountered incidentally during a treatment of another knee pathology as an asymptomatic entity or can be a symptomatic pathology which warrant treatment Case presentation: There were 8 cases of symptomatic discoid meniscus reported in this retrospective case series. The symptoms presented at age range 16-47 year-old. Majority of the case (6 of 8) are lateral discoid meniscus with female gender predominant. Complete type of discoid meniscus was also found in 6 of 8 cases. There were 5 cases of ruptured discoid meniscus, three of them needed repair. Conclusions: Symptomatic discoid meniscus can be presented on wide range of age of patients. We found female gender, discoid lateral meniscus, and complete type are the predominant pattern of discoid meniscus cases presentation.
Medial and Lateral Discoid Menisci of Both Knees
Knee surgery & related research, 2016
Discoid menisci on both the medial and lateral sides are rare, and there are very few reports on cases involving both sides. We report a case of a 52-year-old female with medial and lateral discoid menisci in both knees. Arthroscopy revealed the lateral menisci of both knees were complete discoid menisci, and partial meniscectomy was performed. The medial menisci were incomplete discoid menisci, but there were no findings of abnormal mobility or injury; therefore, the medial menisci were observed without treatment. At six months postoperatively, her pain and range of motion restrictions disappeared.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2004
We present the cases of 5 patients with a torn discoid lateral meniscus treated using partial central meniscectomy in conjunction with the suture repair of the tear. The patients were 4 boys and 1 girl with a mean age of 15.4 years (range, 11 to 17). Preoperatively, all patients complained of knee pain during daily or sports activities. At the final follow-up evaluation, more than 2 years later, 4 patients' conditions were graded as excellent and 1 patient's condition was graded as fair according to Ikeuchi's grading scale. The average Lysholm score improved from 83.4 points (range, 70-90) to 95.8 points (range, 89-100) postoperatively. In the 3 patients who underwent second-look arthroscopy, complete healing was seen in 2 patients. One patient had severe degenerative changes in the meniscus; the repaired site was not united and required an additional partial meniscectomy along the tear. We believe that with the current advancement in arthroscopic meniscal repair techniques, a partial central meniscectomy in conjunction with the suture repair of the peripheral tear can be effective treatment for patients with a torn complete or incomplete discoid meniscus.