Prevalence of Discoid Meniscus During Arthroscopy for Isolated Lateral Meniscal Pathology in the Pediatric Population

Ellis, Henry B.; Wise, Kelsey; LaMont, Lauren E.; Copley, Lawson A.; Wilson, Philip L.

doi:10.1097/bpo.0000000000000630

Cited by 30 publications

(46 citation statements)

References 28 publications

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“…This study also found that only a third of all the patients with SDLM reported exact trauma history, which was consistent with the study of Ellis [ 18 ]. It suggested the absence of any causal relation between symptoms and trauma.…”

Section: Discussionsupporting

confidence: 92%

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

Chen

Zhong

2016

BMC Musculoskelet Disord

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BackgroundDiscoid lateral meniscus (DLM) is relatively common in East Asia..Symptomatic discoid lateral meniscus (SDLM) is an important indication for knee arthroscopic surgery. However, studies investigating SDLM are rare. The purpose of this study was to evaluate the clinical characteristics and intra-articular variants of SDLM in a Chinese population.MethodsWe retrospectively reviewed all patients with SDLM from January 2005 to December 2014 in our hospital. Clinical variables included gender, age, duration, age of onset, affected side, symptoms and trauma history as well as arthroscopic findings: DLM types, tear patterns and concomitant medial meniscus tear, which were evaluated and compared statistically.ResultsOf the 496 consecutive participants with SDLM, females outnumbered males (69.6 % vs. 30.4 %). The age of onset ranged from 3 to 80 years (median, 31 years), and was significantly higher in females than in males (p < 0.0001). Trauma history in males was significantly higher than in females (45 % vs. 35.1 %, p = 0.0356). Males showed a higher incidence of popping and snapping, while females manifested higher range-of-motion (ROM) limitations (p = 0.0179, and p = 0.0392, respectively). No significant difference in intra-articular variants was observed between genders. The complete type was the most frequent (344, 69.4 %), followed by the incomplete type (149, 30 %), and the Wrisberg type (3, 0.6 %). Significant difference in tear patterns was found between complete and incomplete types (p < 0.0001). Few patients showed medial meniscus tear (11, 2.2 %), at a significantly higher age compared with patients without tear (median, 57 years vs. 33 years, p < 0.0001).ConclusionsThe majority of Chinese patients with SDLM are young and middle-aged females. Female patients had an older age of onset, higher incidence of ROM limitation and limited trauma history. The complete type is the most common, with tear patterns varying between complete and incomplete types. The SDLM does not significantly affect the medial meniscus.

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Section: Discussionsupporting

confidence: 92%

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

Chen

Zhong

2016

BMC Musculoskelet Disord

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“…They found the incidence of symptomatic discoid lateral menisci to be 3.2 per 100,000. 51 Ellis et al 24 indicated, in a recent publication, that 97% of patients younger than 13 years with lateral meniscal abnormalities had a discoid lateral meniscus, and 66% of these patients had atraumatic presentation of their pain. For this reason, the early identification of patients with discoid menisci may be beneficial to allow for an early diagnosis and subsequent intervention.…”

Section: Discussionmentioning

confidence: 99%

Demographics and Epidemiology of Discoid Menisci of the Knee: Analysis of a Large Regional Insurance Database

Grimm

Pace

Levy

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: A discoid meniscus is a morphological variant of normal knee joint meniscus shape and ultrastructure that can lead to traumatic tearing of this tissue and early joint osteoarthritis. Purpose/Hypothesis: The purpose of this study was to determine the prevalence of discoid menisci in a large, ethnically diverse regional cohort and to evaluate possible risk factors. The hypothesis was that there would be no difference in the epidemiological distribution of discoid menisci based on ethnicity or sex. Study Design: Descriptive epidemiology study. Methods: The study population was from a regional, integrated health care system cohort from Kaiser Permanente of Southern California that, as of 2016, included more than 4.5 million patients. Patient demographics included age, sex, and ethnicity within this cohort. Potential risk factors analyzed included age, sex, ethnicity, and body mass index (BMI). Unique characteristics of a discoid meniscus were analyzed, including a symptomatic versus asymptomatic meniscus, location of meniscal tear and type of meniscus, and frequency of meniscal surgical treatment. Results: A total of 223 patients with a confirmed discoid meniscus were identified, yielding an overall prevalence rate of 4.88 per 100,000 patients. Those identifying as Black had the lowest prevalence (2.68/100,000), while Hispanic ethnicity had the highest (6.01/100,000). However, there was no significant difference with regard to ethnicity ( P = .283), nor any significant difference between sexes. BMI did not significantly influence the rate of discoid menisci ( P = .504). A majority (77.5%) of patients were symptomatic, while 22.5% of patients with discoid menisci were asymptomatic and discovered incidentally. Symptomatic discoid menisci were more likely to be operated on compared with asymptomatic discoid menisci (71% vs 14%, respectively; P = .001; odds ratio, 14.8 [95% CI, 5.8-37.2]). Horizontal and bucket-handle tears were the more common tear types. Of the discoid menisci in this cohort, 55.6% underwent surgery, with 95.2% undergoing reported saucerization. Conclusion: In this very diverse population-based cohort of patients, there did not seem to be a significant predilection of discoid menisci with regard to ethnicity. Neither sex nor BMI significantly influenced the rate of discoid menisci. More than three-quarters of those with a diagnosed discoid meniscus were symptomatic. Of the tears that occurred with discoid menisci, horizontal and bucket-handle tears made up the largest proportion.

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“…Certainly some patients have symptoms of clunking and even locking at a very young age, but some have pain which requires surgery. [23][24][25][26] It is equally certain that many patients go through their entire lives with a discoid meniscus without any problems.…”

Section: Associated Problemsmentioning

confidence: 99%

The Natural History of Meniscus Tears

Chambers

2019

Journal of Pediatric Orthopaedics

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Background: In order to determine whether treatments are effective in the treatment of meniscus tears, it is first necessary to understand the natural history of meniscus tears. The purpose of this paper is to review the literature to ascertain the natural history of meniscus tears in children and adolescents. Methods: A search of the Pubmed and Embase databases was performed using the search terms "meniscus tears," "natural history of meniscus tears," "knee meniscus," "discoid meniscus," and "natural history of discoid meniscus tears." Results: A total of 2567 articles on meniscus tears, 28 articles on natural history of meniscus tears, 8065 articles on "menisci," 396 articles on "discoid meniscus," and only 2 on the "natural history of discoid meniscus" were found. After reviewing the titles of these articles and reviewing the abstracts of 237 articles, it was clear that there was little true long-term natural history data of untreated meniscus tears nor whether treating meniscus tears altered the natural history. Twenty-five articles were chosen as there was some mention of natural history in their studies. Conclusions: There are few long-term data on untreated meniscal tears or discoid meniscus, or tears in children and adolescents. The literature suggests that there is a higher incidence of chondral injury and subsequent osteoarthritis, but there are many confounding variables which are not controlled for in these relatively short-term papers.

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Prevalence of Discoid Meniscus During Arthroscopy for Isolated Lateral Meniscal Pathology in the Pediatric Population

Abstract: Level III-diagnostic.

Cited by 30 publications

References 28 publications

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

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

Demographics and Epidemiology of Discoid Menisci of the Knee: Analysis of a Large Regional Insurance Database

The Natural History of Meniscus Tears

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