Discoid Lateral Meniscus Tears and Concomitant Articular Cartilage Lesions in the Knee

Fu, Dejie; Guo, Lin; Liu, Yang; Chen, Guangxing; Duan, Xiaojun

doi:10.1016/j.arthro.2013.11.029

Cited by 36 publications

(61 citation statements)

References 43 publications

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“…DLM tears are known to be related to articular cartilage lesions. 6 However, the biomechanical characteristics of DLM are still unknown, and thus orthopaedic surgeons should know whether the remaining DLM is still functional. According to previous reports, total or subtotal meniscectomy has been favorable for symptomatic DLM.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Visualization of Abnormal Movement of Discoid Lateral Meniscus With Snapping Phenomenon

Harato

Niki

Nagashima

et al. 2015

Arthroscopy Techniques

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Discoid lateral meniscus with snapping phenomenon is a rare pathologic condition. The purpose of this article is to present an arthroscopic technique for the treatment of discoid lateral meniscus with snapping phenomenon. The patient is placed in the supine position for confirmation of snapping. As the patient's knee bends, it can be confirmed by arthroscopy that the posterior horn of the discoid lateral meniscus moves posteriorly and the central portion of the discoid lateral meniscus moves anteriorly at the same time with snapping at deep flexion angles. The anterior segment of the discoid lateral meniscus is found to be redundant and is often folded. On the contrary, as the patient's knee extends, the central portion is returned to the original position accompanied by snapping at nearly full extension. After excision of the central portion, the movement of the meniscus is evaluated again and the disappearance of the snapping phenomenon can be confirmed. Although it includes limitations, this application is easy and would certainly help surgeons to treat snapping knee with discoid lateral meniscus.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Visualization of Abnormal Movement of Discoid Lateral Meniscus With Snapping Phenomenon

Harato

Niki

Nagashima

et al. 2015

Arthroscopy Techniques

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“…Compared with males, on one hand, females have increased rates of cartilage loss and progression of cartilage defects at the knee [20]. On the other hand, the knee articular cartilage volume is smaller and the Q angle is greater in females [13,14,17]. Thus, females are more susceptible to cartilage lesions and osteoarthritis [20] and being female is associated with poor postoperative clinical outcomes.…”

Section: Univariate Analysis Of the Correlation Between The Investigamentioning

confidence: 99%

“…Symptomatic DLM, characterized by pain, swelling, snapping, locking, knee instability and limited mobility [12,27], is mainly diagnosed by magnetic resonance imaging (MRI) and treated by arthroscopic surgery [31]. Although the overall postoperative clinical outcomes of symptomatic DLM are acceptable [11,17,38], the outcomes still differ among individuals, possibly as a result of the diversity in patient characteristics and treatments [31]. Recently studies have reported several factors that in uence postoperative effect in symptomatic DLM, but the sample sizes used in these studies are uneven, and the results are inconsistent [10][11]19,28].…”

Section: Introductionmentioning

confidence: 99%

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Yang

Ding

et al. 2020

Preprint

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Background: Due to its abnormal morphology and ultrastructure, discoid lateral meniscus (DLM) is prone to tear and degeneration, leading to clinical symptoms. Arthroscopy is the main treatment for symptomatic DLM; however, postoperative outcomes vary widely due to the effects of diverse factors. This research aims to explore the factors influencing postoperative outcomes of symptomatic DLM. Methods: Patients with DLM who underwent arthroscopic surgery at our hospital from 9/2008 to 9/2015 were enrolled according to the inclusion and exclusion criteria. Fourteen variables, including sex, body mass index (BMI) and other variables, were chosen as factors for study. Knee function was assessed using the International Knee Documentation Committee (IKDC) score. Univariate analyses (Mann-Whitney U test or Kruskall-Wallis rank sum test) and multivariate analyses (ordinal logistic regression) were used to identify the factors that influenced postoperative outcomes. P<0.05 was considered statistically significant.Results: A total of 502 patients, including 353 females (70.3%) and 149 males (29.7%), were enrolled. The median IKDC score postoperatively (87.4; range, 41.4~97.7; IQR, 14.6) was higher than that preoperatively (57.6; range, 26.9~ 64.9; IQR, 9.7) (P<0.001). Male sex was predictive of a higher IKDC score (P=0.023, OR=1.702). Compared with BMI ≥25 kg/m2, <18.5 kg/m2 was associated with better IKDC score (P=0.026, OR=3.016). Contrasting with age of onset ≥45 years, ≤14 years (P<0.001, OR=20.780) and 14~25 years (P<0.001, OR=8.516) were associated with better IKDC score. In comparison with symptoms duration>24 months, IKDC scores for patients with symptoms duration ≤1 month (P=0.001, OR=3.511), 1 ~ 6 months (P < 0.001, OR = 3.463) and 6 ~ 24 months (P < 0.001, OR = 3.254) were significantly elevated. Compared to Outerbridge grade III ~ IV, no injury (P<0.001, OR=6.379) and grade I (P=0.01, OR=4.332) were associated with higher IKDC score.Conclusions: Arthroscopic treatment of symptomatic DLM is safe and effective, but its clinical efficacy is affected by many factors. Specifically, male sex, BMI < 18.5kg/m2, age of onset < 25 years (especially < 14 years) and symptoms duration < 24 months are conducive to good postoperative outcomes. However, combined articular cartilage injury (Outbridge grade≥2) reduces postoperative effect.

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“…8 Recent literature also supports a timely repair for isolated discoid meniscal tears to decrease the incidence of articular cartilage lesions. 9 The orthopaedic surgeon preparing to address a torn lateral meniscus should be equipped to handle an unstable discoid meniscus. The advantages of the described technique (Table 1) are that we use standard knee arthroscopic skills combined with an inside-out repair technique coupled with a high-strength partially absorbable vertical mattress suture configuration.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Saucerization and Repair of Discoid Lateral Meniscal Tear

Fields

Caldwell

2015

Arthroscopy Techniques

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Meniscal tears are among the most commonly diagnosed knee injuries and often require surgical intervention. Understanding the types of meniscal tears and treatment options is paramount to caring for the young athlete. Sports medicine and arthroscopic physicians now recognize that meniscal preservation in the young athlete is essential to the longterm health and function of the knee. Although uncommon, the discoid lateral meniscus is more prone to injury because of its increased thickness and lack of blood supply. Because of the abnormal development, the peripheral attachments are frequently absent and instability often persists after a partial meniscectomy. If the instability is unrecognized during the initial treatment, a recurrence of pain and mechanical symptoms is likely and a subsequent subtotal meniscectomy may be the only treatment option. With increased awareness, arthroscopic saucerization accompanied by arthroscopically assisted inside-out meniscal repair is a preferable treatment option with an excellent outcome.

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Discoid Lateral Meniscus Tears and Concomitant Articular Cartilage Lesions in the Knee

Cited by 36 publications

References 43 publications

Arthroscopic Visualization of Abnormal Movement of Discoid Lateral Meniscus With Snapping Phenomenon

Arthroscopic Visualization of Abnormal Movement of Discoid Lateral Meniscus With Snapping Phenomenon

Influential factors of postoperative outcomes of symptomatic lateral discoid meniscus

Arthroscopic Saucerization and Repair of Discoid Lateral Meniscal Tear

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