Symptomatic Anomalous Insertion of the Medial Meniscus

Nakajima, Tetsuo; Nabeshima, Yuji; Fujii, Hideo; Ozaki, Akihiro; Muratsu, Hirotsugu; Yoshiya, Shinichi

doi:10.1016/j.arthro.2005.02.002

Cited by 12 publications

(12 citation statements)

References 5 publications

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“…The same operation and outcome were also reported by Nakajima et al. 14 However, Rainio et al. 12 described 11 patients with anomalous insertions, among whom only 1 considered that resection of the anomalous insertion relieved the pain.…”

Section: Discussionsupporting

confidence: 60%

“…Nakajima et al. 14 reported that the pathology of the anomalous insertion is fibrocartilaginous tissue, as in other parts of the meniscus. Arjun et al.…”

Section: Discussionmentioning

confidence: 99%

“…Nakajima et al 14 reported that the pathology of the anomalous insertion is fibrocartilaginous tissue, as in other parts of the meniscus. Arjun et al 15 reported that the anomalous insertion consisted of fibrous cartilage tissue, and Nagashima et al 16 found that the anomalous insertion consisted of loose fibrous connective tissues.…”

Section: Discussionmentioning

confidence: 99%

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Anomalous insertion of the anterior horn of the medial meniscus combined with anterior horn hypertrophy and a synovial cyst: case report and literature review

et al. 2021

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Objective To gain a greater understanding of anomalous insertions of the anterior horn of the medial meniscus through evaluation of a rare case and a review of the existing literature on medial meniscus malformations. Methods This report describes a 26-year-old man with an anomalous insertion of the anterior horn of the medial meniscus combined with symptomatic hypertrophy of the anterior horn and a synovial cyst. We also conducted a review of the existing literature on medial meniscus malformations using five major scholarly literature databases and search engines. Results The literature review revealed that the incidence of anomalous insertions of the anterior horn of the medial meniscus is 0.5% to 2.8%. Not all patients undergo surgical excision; some are only symptomatically treated. In our patient, the arthroscopic view was consistent with the imaging characteristics. No special operation was performed to treat the anomalous insertion. At the 18-month follow-up, the patient had no symptom recurrence and had returned to practicing sports. Conclusion The pain during hyperextension in our patient was caused by a cyst and anterior horn hypertrophy. If the symptoms in such cases are not caused by the anomalous insertion, no special treatment is needed.

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Section: Discussionsupporting

confidence: 60%

“…Nakajima et al. 14 reported that the pathology of the anomalous insertion is fibrocartilaginous tissue, as in other parts of the meniscus. Arjun et al.…”

Section: Discussionmentioning

confidence: 99%

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Anomalous insertion of the anterior horn of the medial meniscus combined with anterior horn hypertrophy and a synovial cyst: case report and literature review

et al. 2021

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“…e4 AMKP before arthroscopic surgery. 6,7 In contrast, Kim et al 17 reported reshaping of the discoid LM alone relieved symptoms in patients with this anomaly and discoid LM. In our study, none of the patients experienced AMKP before the surgery, and none of the patients developed subsequent AKMP.…”

Section: Discussionmentioning

confidence: 94%

“…2e5 The anomalous insertion of the AHMM has long been speculated to be a potential cause of anteromedial knee pain (AMKP), because some cases show resolution of AMKP after resection of the anomaly. 6,7 However, in cases in which the anomaly is observed unexpectedly during arthroscopic surgery in a patient without AMKP, whether resection of the anomaly is necessary remains unclear. Recently, Kim and Joo 5 described the preoperative clinical, arthroscopic, and magnetic resonance imaging (MRI) findings of knees with anomalous insertion of the AHMM in detail.…”

mentioning

confidence: 99%

Benign Neglect of Anomalous Insertion of the Anterior Horn of the Medial Meniscus as an Incidental Finding During Knee Arthroscopy

Nagashima

Otani

Takeshima

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To evaluate the clinical results following arthroscopic surgery in patients with anomaly of the anterior horn of the medial meniscus (AHMM) that was found unexpectedly during surgery and discuss whether resection is necessary in patients without anteromedial knee pain (AMKP). Methods: Between May 2014 and April 2017, a total of 387 knee arthroscopies in 379 patients were performed. Among these, 11 knees in 11 patients showed an anomalous insertion of the AHMM (incidence, 2.8%), and all 11 patients were included in this study. For these 11 patients, medical records including preoperative diagnosis, arthroscopic findings, and pre-and postoperative clinical evaluations were analyzed. Results: None of the patients complained of AMKP before arthroscopy. Two patients were diagnosed with lateral meniscus injury and the other 9 patients were diagnosed with medial meniscus injury. All anomalies of the AHMM were found incidentally during arthroscopic surgery. The anomaly formed a band-like structure arising from the anterior portion of the medial meniscus and was attached to the anterior aspect of the ACL and femoral intercondylar notch. All 11 patients underwent partial meniscectomy, but anomalies of the AHMM were not resected. One patient was excluded from clinical evaluation, as that patient required subsequent total knee arthroplasty due to osteoarthritis. For the other 10 patients, mean follow-up was 36.8 months (range, 26-61 months). Knee pain was relieved, and none developed postoperative AMKP. Mean Lysholm score improved significantly from 55.9 to 91.2 (P < .001). Conclusions: The incidence of the anomaly was 2.8% in our study. If the patient has no AMKP before arthroscopic surgery, anomaly of the AHMM is a silent lesion that does not warrant resection. Level of Evidence: Level IV, therapeutic case series

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Repair of a torn medial meniscus with an anteromedial meniscofemoral ligament in an anterior cruciate ligament-injured knee

Hamada

Miyama

Nagayama

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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We report a rare case of longitudinal tear of the anterior segment of the medial meniscus in association with the anteromedial meniscofemoral ligament (AMMFL) in an anterior cruciate ligament-injured knee. The tear was repaired, and the anterior horn was transferred to the tibia using the pull-out technique after excising the AMMFL. Repeat arthroscopy performed 7 months postoperatively revealed that the medial meniscus had completely healed and the anterior horn was firmly fixed to the tibia. Two years after the surgery, the patient could play basketball without any symptom. A posteroanterior flexion weight-bearing radiograph did not show any narrowing of the medial joint space. Considering the excellent healing observed in this case, preservation of the meniscus should be considered despite an association between a torn meniscus and an anomalous insertion.

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Symptomatic Anomalous Insertion of the Medial Meniscus

Cited by 12 publications

References 5 publications

Anomalous insertion of the anterior horn of the medial meniscus combined with anterior horn hypertrophy and a synovial cyst: case report and literature review

Anomalous insertion of the anterior horn of the medial meniscus combined with anterior horn hypertrophy and a synovial cyst: case report and literature review

Benign Neglect of Anomalous Insertion of the Anterior Horn of the Medial Meniscus as an Incidental Finding During Knee Arthroscopy

Repair of a torn medial meniscus with an anteromedial meniscofemoral ligament in an anterior cruciate ligament-injured knee

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