Prevalence of bilateral Discoid Lateral Menisci (DLM) in patients operated for symptomatic DLM with a follow-up study on their asymptomatic contralateral knees: a Magnetic Resonance Imaging (MRI) assessment

Abstract

BackgroundThe purpose was to investigate prevalence of bilateral discoid lateral menisci (DLM) in Han Chinese patients who received surgery for symptomatic DLM, as well as a follow-up study of their asymptomatic contralateral knees using magnetic resonance imaging (MRI).MethodsA total of 110 patients [50 males and 60 females; average age: 21.95 ± 12.77 years (range: 6 to 67 years)] admitted to our hospital with symptomatic DLM were treated with arthroscopic surgery. The contralateral asymptomatic knees were evaluated for DLM by MRI. Postoperative clinical evaluation was performed using the Lysholm knee scoring scale and International Knee Documentation Committee subjective knee evaluation.ResultsEighty (72.73 %) of 110 symptomatic DLM patients had bilateral DLM, of which 68 (85 %) were of homotype (same type). Fourteen of 80 bilateral DLM patients were symptomatic and received operations in both knees. Twelve of remaining 66 bilateral DLM patients with asymptomatic one knee underwent a second arthroscopic surgery as their asymptomatic knees became symptomatic over the five-year interim. Of these 12 cases, seven exhibited no shift and five showed posterocentral meniscal shift. Furthermore, at least two cases showed progression from asymptomatic grade II to symptomatic grade III over the interim. All patients showed significant improvement after surgery.ConclusionsThe bilateral DLM rate of Han Chinese patients with symptomatic DLM was relatively high at 72.7 %, and 85 % of those were of homotype.

Comparison between conservative and prophylactically concurrent meniscoplasty on the asymptomatic knee in children with unilaterally symptomatic bilateral discoid lateral meniscus operated on the symptomatic side: a retrospective study and literature review

“…Liu et al conducted a follow-up of the asymptomatic knees and found that, 12 out of 66 patients reported occurrence of symptoms in a veyear follow-up, among which 5 showed posterocentral meniscal shift. Therefore, they suggested that prophylactic meniscoplasty may be a better choice for patients with bilateral DLM and undergone detailed physical and radiographical evaluations (23). This study happened to have the same view with Liu and his colleagues (23), and clinical results of follow-ups and plan for conservative treatment were presented in children with unilaterally symptomatic bilateral discoid lateral meniscus operated on the symptomatic side.…”

“…Additionally, whether the asymptomatic side of patients with bilateral DLM should receive routine screening and undergo arthroscopy is still being debated. Some studies assessed the asymptomatic knee of the nonoperated side and suggested regular evaluation by MRI and X-rays in follow-ups (18,23,33), and some research mentioned no treatment for children with asymptomatic DLM (24,26,34,35). However, few discussed the reason.…”

Symptomatic discoid lateral meniscus: a clinical and arthroscopic study in a Chinese population

“…In another study [ 16 ], 79 % of the patients with unilateral SDLM had contralateral DLM. Liu et al [ 17 ] reported that 85 % of bilateral DLM manifested homotype. However, bilateral DLM was often observed with only unilateral occurrence of symptoms [ 4 ].…”

Editorial Commentary: Why Should the Contralateral Side Be Examined in Patients With Symptomatic Discoid Lateral Meniscus?

“…5 Recently, additional studies have reported the prevalence of bilateral DLM to be from 73% to 85% according to bilateral arthroscopic examination or MRI evaluation. [6][7][8] Furthermore, these reports have demonstrated associated meniscus tears on the contralateral side at a rate of 4% to 33% in patients with symptomatic, unilateral surgical DLM. [5][6][7][8] Few studies have identified potential factors that may predict the survivorship of the contralateral meniscus in patients with DLM, however.…”

“…[6][7][8] Furthermore, these reports have demonstrated associated meniscus tears on the contralateral side at a rate of 4% to 33% in patients with symptomatic, unilateral surgical DLM. [5][6][7][8] Few studies have identified potential factors that may predict the survivorship of the contralateral meniscus in patients with DLM, however.…”