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Management of discoid lateral meniscus tears: Observations in 34 knees

      Abstract

      Purpose: The goal of this study was to evaluate arthroscopic partial resection of discoid lateral meniscus tears with an emphasis on radiographic evidence of degenerative changes after this procedure. Type of Study: Retrospective clinical study. Methods: Of 41 patients with an arthroscopic diagnosis of discoid meniscus over an 8-year period, 34 symptomatic lateral discoid meniscus tears in 33 patients were analyzed at an average follow-up of 5.6 years. The average age at operation was 19.8 years and most patients had vague and intermittent symptoms that caused delay in clinical diagnosis. Results: Eight patients were lost to follow-up and were excluded from the study. Magnetic resonance imaging, performed in 12 cases, and arthroscopy in all of these patients provided the precise diagnosis. All of the knees with symptomatic torn discoid menisci underwent arthroscopic partial meniscectomy. Only 1 Watanabe Wrisberg ligament type of discoid meniscus with posterior instability was totally meniscected. Based on Ikeuchi's grading, 39% of the knees had an excellent result, 46% had a good result, and 15% had a fair result; none of the results was poor. Conclusions: At an average 5-year follow-up, partial meniscectomy in patients with a Watanabe complete or incomplete discoid meniscus showed 85% good or excellent clinical results. However, a significant percentage of patients show femoral condyle flattening on radiography.
      Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 19, No 4 (April), 2003: pp 346–352

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      References

        • Young RB
        The external semilunar cartilage as a complete disc: Memoirs and memoranda in anatomy.
        Williams and Nortage, London1889
        • Dichault SC
        • DeLee JC
        The discoid lateral meniscus syndrome.
        J Bone Joint Surg Am. 1982; 64: 1068-1073
        • Ikeuchi H
        Arthroscopic treatment of lateral discoid meniscus: Technique and long-term results.
        Clin Orthop. 1982; 167: 19-28
        • Jeannopoulos CL
        Observation of discoid menisci.
        J Bone Joint Surg Am. 1950; 32: 649-652
        • Noble J
        Lesions of the menisci: Autopsy incidence in adults less than fifty-five years old.
        J Bone Joint Surg Am. 1977; 59: 480-483
        • Smillie IS
        The congenital discoid meniscus.
        J Bone Joint Surg Br. 1948; 30: 671-682
        • Kobayashi A
        • Uezaki N
        • Mitsuyasu M
        Discoid meniscus of the knee joint.
        Clin Orthop. 1975; 10: 10-24
        • Raber DA
        • Friederich NF
        • Hefti F
        Discoid lateral meniscus in children.
        J Bone Joint Surg Am. 1998; 80: 1579-1586
        • Washington ER
        • Root L
        • Liener UC
        Discoid lateral meniscus in children.
        J Bone Joint Surg Am. 1995; 77: 1357-1361
        • Hayashi KL
        • Yamaga H
        • Ida K
        • et al.
        Arthroscopic meniscectomy for discoid lateral meniscus in children.
        J Bone and Joint Surg Am. 1989; 78: 1495-1500
        • Kim SJ
        • Lee YT
        • Choi CH
        • et al.
        A partially duplicated discoid lateral meniscus.
        Arthroscopy. 1998; 14: 518-521
        • Cargill AOR
        • Jackson JP
        Bucket-handle tear of the medial meniscus.
        J Bone Joint Surg Am. 1976; 58: 248-251
        • Fujikawa K
        • Iseki F
        • Mikura Y
        Partial resection of the discoid meniscus in the child's knee.
        J Bone Joint Surg Br. 1981; 63: 391-395
        • McGinty JB
        • Geuss LF
        • Marvin RA
        Partial or total meniscectomy.
        J Bone Joint Surg Am. 1977; 59: 763-766
        • Watanabe M
        • Takeda S
        • Kieuchi H
        Atlas of arthroscopy.
        in: ed 3. Igakushoin, Tokyo1979: 88
        • Ahlback S
        Osteoarthrosis of the knee. A radiographic investigation.
        Acta Radiol. 1968; 277: 7-72
        • Hall FM
        Arthrography of the discoid lateral meniscus.
        AJR Am J Roentgenol. 1977; 128: 993-1002
        • Kaplan EB
        Discoid lateral meniscus of the knee joint: Nature, mechanism, and operative treatment.
        J Bone Joint Surg Am. 1957; 39: 77-87
        • Le Minor JM
        Comparative morphology of the lateral meniscus of the in primates.
        J Anat. 1990; 170: 161-171
        • Albertsson M
        • Gillquist J
        Discoid lateral menisci: A report of 29 cases.
        Arthroscopy. 1988; 4: 211-214
        • Berson BL
        • Herman G
        Torn discoid menisci of the knee in adults: Four case reports.
        J Bone Joint Surg Am. 1979; 61: 303-304
        • Corso SJ
        • Bochner RM
        Bilateral discoid lateral meniscus in the seventh decade: A case report.
        Am J Knee Surg. 1990; 3: 139-142
        • Aichroth PM
        • Patel DV
        • Marx CL
        Congenital discoid lateral meniscus in children.
        J Bone Joint Surg Br. 1991; 73: 932-936
        • Atay Ö A
        • Doral MN
        • Aksoy MC
        • et al.
        Arthroscopic partial resection of the discoid meniscus in children.
        Turk J Pediatr. 1997; 39: 505-510
        • Bellier G
        • Dupont JY
        • Larrain M
        • et al.
        Lateral discoid menisci in children.
        Arthroscopy. 1989; 5: 52-56
        • Silverman JM
        • Mink JH
        • Deutsch AL
        Discoid menisci of the knee: MR imaging appearance.
        Radiology. 1989; 173: 351-354
        • Hamada M
        • Shino K
        • Kawano K
        • et al.
        Usefulness of magnetic resonance imaging for detecting intrasubstance tear and/or degeneration of lateral discoid meniscus.
        Arthroscopy. 1994; 10: 645-653
        • Ryu KN
        • Kim IS
        • Kim EJ
        • et al.
        MR imaging of tears of discoid lateral menisci.
        AJR Am J Roentgenol. 1998; 171: 963-967
        • Pellaci P
        • Montanari G
        • Prosperi P
        • et al.
        Lateral discoid meniscus: Treatment and results.
        Arthroscopy. 1992; 8: 526-530
        • Vandermeer RD
        • Cunningham K
        Arthroscopic treatment of the lateral discoid menicus: Results of long term follow-up.
        Arthroscopy. 1989; 5: 101-109
        • Dimakopoulus P
        • Patel D
        Partial excision of discoid meniscus.
        Acta Orthop Scand. 1989; 60: 40-41
        • Kim SJ
        • Yoo JH
        • Kim HK
        Arthroscopic one-piece excision technique for the treatment of symptomatic lateral discoid meniscus.
        Arthroscopy. 1996; 12: 752-755
        • Manzione M
        • Pizzutillo PD
        • Peoples AB
        • Schweizer PA
        Meniscectomy in children: A long term follow-up study.
        Am J Sports Med. 1983; 11: 111-115
        • Fritschy D
        • Gonseth D
        Discoid lateral meniscus.
        Int Orthop. 1991; 15: 145-147
        • Sugawara O
        • Miyatsu M
        • Yamashita I
        Problems with repeated arthroscopic surgery in the discoid meniscus.
        Arthroscopy. 1991; 7: 68-71
        • Clark CR
        • Ogden JA
        Development of the menisci of the human knee joint.
        J Bone Joint Surg Am. 1983; 65: 538-547