Discoid Medial Meniscus Tear, with a Literature Review of Treatments

Abstract

The present study reports our experience of treating four cases of symptomatic discoid medial meniscus, three of which were bilateral. We performed partial meniscectomy with a four-portal technique using a knife leaving a 6 mm peripheral margin after confirmation of magnetic resonance imaging findings. Clinical results were assessed at the end of 2-year follow-up using the Knee Injury and Osteoarthritis Outcome Score and a visual analogue scale. We obtained satisfactory clinical results without recurrence of the symptoms in all cases.

A Useful MRI Classification for Symptomatic Discoid Lateral Meniscus

“…Symptomatic DLM is usually associated with tears or instability, and symptomatic DLM is known to require treatment [ 5 , 6 ]. In the treatment, central partial meniscectomy (saucerization) and repair as needed have shown to be more successful than total meniscectomy [ 7 – 9 ].…”

Arthroscopic Saucerization of a Symptomatic Posterior Horn Tear in a Discoid Medial Meniscus

“…19 A literature review yielded 3 surgical approaches in addition to the standard 2-portal approach for treating symptomatic discoid medial meniscus tears. 10,19,20 The standard 2-portal approach uses an anterolateral viewing portal and anteromedial working portal and is considered the gold standard for diagnostic knee arthroscopy but can also be used to treat discoid medial meniscus using the well-characterized inside-out technique. 21,22 Treatment of posterior horn tears in a discoid medial meniscus using the 2-portal approach requires a larger valgus stress to extend the medial compart-ment compared to visualization of a discoid lateral meniscus, increasing the risk of iatrogenic medial collateral ligament injury.…”

“…Song et al described a 4-portal technique for convenient saucerization without risking anterior cartilage damage. 10 Their additional high far lateral and low anteromedial portals allowed easy determination of remnant margins after saucerization. This 4-portal approach can be ideal for anterior horn tears of the discoid medial meniscus; however, visualization of the posterior horn is limited.…”

“…5 Although an extremely rare entity with fewer than 70 reported cases worldwide, discoid medial meniscus has been well characterized in the literature. [6][7][8][9][10] Arthroscopic treatment techniques have also been described. 11 Discoid lateral meniscus is another anatomic variant and is also well described in the literature, with an estimated inci-dence of up to 5% of the US population.…”

“…5 Although an extremely rare entity with fewer than 70 reported cases worldwide, discoid medial meniscus has been well characterized in the literature. 6 - 10 Arthroscopic treatment techniques have also been described. 11 …”