Diagnosis and Treatment of Discoid Meniscus

Kim, Jae Gyoon; Han, Seong Woo; Lee, Dong Hoon

doi:10.5792/ksrr.16.050

Cited by 66 publications

(66 citation statements)

References 58 publications

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“…Since the first observation and description of discoid meniscus, which was more frequently seen laterally than medially, it is established that it is more prone to tearing than a normal meniscus. 102 The current management depends mostly on the symptomatology of the patient. Asymptomatic discoid meniscus is classically treated conservatively.…”

Section: Management Of Special Lesionsmentioning

confidence: 99%

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Modern treatment of meniscal tears

et al. 2018

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The complex ultrastructure of the meniscus determines its vital functions for the knee, the lower extremity, and the body.The most recent concise, reliable, and valid classification system for meniscal tears is the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Classification, which takes into account the subsequent parameters: tear depth, tear pattern, tear length, tear location/rim width, radial location, location according to the popliteal hiatus, and quality of the meniscal tissue.It is the orthopaedic surgeon’s responsibility to combine clinical information, radiological images, and clinical experience in an effort to individualize management of meniscal tears, taking into account factors related to the patient and lesion.Surgeons should strive not to operate in most cases, but to protect, repair or reconstruct, in order to prevent early development of osteoarthritis by restoring the native structure, function, and biomechanics of the meniscus.Currently, there are three main methods of modern surgical management of meniscus tears: arthroscopic partial meniscectomy; meniscal repair with or without augmentation techniques; and meniscal reconstruction. Meniscus surgery has come a long way from the old slogan, “If it is torn, take it out!” to the currently accepted slogan, “Save the meniscus!” which has guided evolving modern treatment methods for meniscal tears. This last slogan will probably constitute the basis for newer alternative biological treatment methods in the future.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170067.

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Section: Management Of Special Lesionsmentioning

confidence: 99%

“…If the patient is symptomatic, the preferred method is APM (saucerization) with preservation of the stable peripheral rim, which has seen successful clinical results. 102 …”

Section: Management Of Special Lesionsmentioning

confidence: 99%

Modern treatment of meniscal tears

et al. 2018

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“…Our findings highlight the importance of local Bmp2 activity for synthesis of the extracellular matrix required for the meniscus to attain its unique shape and subsequent function. Without Bmp2 , menisci have a flattened, disklike appearance, a morphology often associated with discoid meniscus, a maturation disorder observed in children that increases susceptibility to tearing due to altered mechanical function . Bmp2 may also be required for the ossification of the anterior meniscal horn, a feature present in mouse menisci that is not observed in humans .…”

Section: Discussionmentioning

confidence: 99%

“…Without Bmp2, menisci have a flattened, disklike appearance, a morphology often associated with discoid meniscus, a maturation disorder observed in children that increases susceptibility to tearing due to altered mechanical function. (32,33) Bmp2 may also be required for the ossification of the anterior meniscal horn, a feature present in mouse menisci that is not observed in humans. (34,35) Interestingly, the time course for the alterations in meniscus and articular cartilage were distinct; the meniscus displayed obvious histological changes earlier than those found on the articular surface, and it may be that alterations in meniscal structure during knee joint morphogenesis have a deleterious effect on the adjacent articular cartilage leading to age-related pathology we observe in both tissues.…”

Section: Discussionmentioning

confidence: 99%

The Role of Bmp2 in the Maturation and Maintenance of the Murine Knee Joint

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Gamer

et al. 2018

Journal of Bone and Mineral Research

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Bone morphogenetic proteins (BMPs) are key regulators of skeletal development, growth, and repair. Although BMP signaling is required for synovial joint formation and is also involved in preserving joint function after birth, the role of specific BMP ligands in adult joint homeostasis remains unclear. The purpose of this study was to define the role of Bmp2 in the morphogenesis and maintenance of the knee joint. To do this, we first created Bmp2-LacZ and Gdf5-LacZ knock-in mice and compared their expression patterns in the developing and postnatal murine knee joint. We then generated a knockout mouse model using the Gdf5-cre transgene to specifically delete Bmp2 within synovial joint-forming cells. Joint formation, maturation, and homeostasis were analyzed using histology, immunohistochemistry, qRT-PCR, and atomic force microscopy (AFM)-based nanoindentation to assess the cellular, molecular, and biomechanical changes in meniscus and articular cartilage. Bmp2 is expressed in the articular cartilage and meniscus of the embryonic and adult mouse knee in a pattern distinct from Gdf5. The knee joints of the Bmp2 knockout mice form normally but fail to mature properly. In the absence of Bmp2, the extracellular matrix and shape of the meniscus are altered, resulting in functional deficits in the meniscus and articular cartilage that lead to a progressive osteoarthritis (OA) like knee pathology as the animals age. These findings demonstrate that BMP activity provided by Bmp2 is required for the maturation and maintenance of the murine knee joint and reveal a unique role for Bmp2 that is distinct from Gdf5 in knee joint biology. © 2018 American Society for Bone and Mineral Research.

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“…Discoid lateral meniscus (DLM) is a common anatomical anomaly of the lateral meniscus frequently reported in the literature [1][2][3][4]. In patients with DLM, the meniscus has a unique shape, with increased thickness and broad coverage of the tibia.…”

Section: Introductionmentioning

confidence: 99%