Original Article| Volume 30, ISSUE 3, P311-318, March 2014

Download started.


Discoid Lateral Meniscus Tears and Concomitant Articular Cartilage Lesions in the Knee


      The purpose of this study was to investigate the relation between isolated discoid lateral meniscus (DLM) tears and the presence of articular cartilage lesions.


      From January 2010 to January 2012, 252 consecutive patients diagnosed with an isolated DLM tear during an arthroscopic procedure were included in this study. Demographic variables, including gender, age, body mass index (BMI), traumatic history, time course, and date of the DLM tear, were recorded. The relation between DLM tears and the presence of articular cartilage lesions was analyzed by the χ2 test. Logistic regression analysis was used to analyze the relation between these variables and articular cartilage lesions.


      Of the patients with DLM tears, 67 (26.6%) also had articular cartilage lesions. The most common type of DLM tear was the complex tear (46.8%). The most common location of articular cartilage lesions was the lateral tibial plateau (11.6%). Lesions on the opposing articular surfaces of the lateral compartment and patellofemoral joint of the knee were found in 12 patients (4.8%) and 11 patients (4.4%), respectively. There were no significant differences in the incidences of articular cartilage lesions in patients with different types of DLM tears (P > .05). Gender (odds ratio [OR], 2.289; P = .012), BMI (OR, 1.991; P = .023), and time course (OR, 2.050; P = .034) were significantly associated with articular cartilage lesions.


      DLM tears were more common in the context of degenerative tears. There was no significant difference in the incidence of articular cartilage lesions among patients with different types of DLM tears. Female patients, patients with a BMI greater than 23.0 kg/m2, or patients with a time course of greater than 6 months were more frequently observed to also have articular cartilage lesions.

      Level of Evidence

      Level IV, therapeutic case series.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Young R.
        The external semilunar cartilage as a complete disc.
        in: Cleland J. Mackey J.Y. Young R.B. Memoirs and memoranda in anatomy. Williams and Norgate, London1889: 179-187
        • Sun Y.
        • Jiang Q.
        Review of discoid meniscus.
        Orthop Surg. 2011; 3: 219-223
        • Ikeuchi H.
        Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results.
        Clin Orthop Relat Res. 1982; : 19-28
        • Kim S.J.
        • Lee Y.T.
        • Kim D.W.
        Intraarticular anatomic variants associated with discoid meniscus in Koreans.
        Clin Orthop Relat Res. 1998; : 202-207
        • Papadopoulos A.
        • Karathanasis A.
        • Kirkos J.M.
        • Kapetanos G.A.
        Epidemiologic, clinical and arthroscopic study of the discoid meniscus variant in Greek population.
        Knee Surg Sports Traumatol Arthrosc. 2009; 17: 600-606
        • Bae J.H.
        • Lim H.C.
        • Hwang D.H.
        • Song J.K.
        • Byun J.S.
        • Nha K.W.
        Incidence of bilateral discoid lateral meniscus in an Asian population: An arthroscopic assessment of contralateral knees.
        Arthroscopy. 2012; 28: 936-941
        • Atay O.A.
        • Pekmezci M.
        • Doral M.N.
        • Sargon M.F.
        • Ayvaz M.
        • Johnson D.L.
        Discoid meniscus: An ultrastructural study with transmission electron microscopy.
        Am J Sports Med. 2007; 35: 475-478
        • Good C.R.
        • Green D.W.
        • Griffith M.H.
        • Valen A.W.
        • Widmann R.F.
        • Rodeo S.A.
        Arthroscopic treatment of symptomatic discoid meniscus in children: Classification, technique, and results.
        Arthroscopy. 2007; 23: 157-163
        • Kurz B.
        • Lemke A.K.
        • Fay J.
        • Pufe T.
        • Grodzinsky A.J.
        • Schunke M.
        Pathomechanisms of cartilage destruction by mechanical injury.
        Ann Anat. 2005; 187: 473-485
        • Han S.B.
        • Shetty G.M.
        • Lee D.H.
        • et al.
        Unfavorable results of partial meniscectomy for complete posterior medial meniscus root tear with early osteoarthritis: A 5- to 8-year follow-up study.
        Arthroscopy. 2010; 26: 1326-1332
        • Bin S.I.
        • Lee S.H.
        • Kim C.W.
        • Kim T.H.
        • Lee D.H.
        Results of arthroscopic medial meniscectomy in patients with grade IV osteoarthritis of the medial compartment.
        Arthroscopy. 2008; 24: 264-268
        • Chatain F.
        • Robinson A.H.
        • Adeleine P.
        • Chambat P.
        • Neyret P.
        The natural history of the knee following arthroscopic medial meniscectomy.
        Knee Surg Sports Traumatol Arthrosc. 2001; 9: 15-18
        • Chatain F.
        • Adeleine P.
        • Chambat P.
        • Neyret P.
        A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up.
        Arthroscopy. 2003; 19: 842-849
        • Pena E.
        • Calvo B.
        • Martinez M.A.
        • Palanca D.
        • Doblare M.
        Why lateral meniscectomy is more dangerous than medial meniscectomy. A finite element study.
        J Orthop Res. 2006; 24: 1001-1010
        • Christoforakis J.
        • Pradhan R.
        • Sanchez-Ballester J.
        • Hunt N.
        • Strachan R.K.
        Is there an association between articular cartilage changes and degenerative meniscus tears?.
        Arthroscopy. 2005; 21: 1366-1369
        • Lewandrowski K.U.
        • Muller J.
        • Schollmeier G.
        Concomitant meniscal and articular cartilage lesions in the femorotibial joint.
        Am J Sports Med. 1997; 25: 486-494
        • Henry S.
        • Mascarenhas R.
        • Kowalchuk D.
        • Forsythe B.
        • Irrgang J.J.
        • Harner C.D.
        Medial meniscus tear morphology and chondral degeneration of the knee: Is there a relationship?.
        Arthroscopy. 2012; 28: 1124-1134.e2
        • Casscells S.W.
        The torn or degenerated meniscus and its relationship to degeneration of the weight-bearing areas of the femur and tibia.
        Clin Orthop Relat Res. 1978; : 196-200
        • Fahmy N.R.
        • Williams E.A.
        • Noble J.
        Meniscal pathology and osteoarthritis of the knee.
        J Bone Joint Surg Br. 1983; 65: 24-28
        • Mainil-Varlet P.
        • Aigner T.
        • Brittberg M.
        • et al.
        Histological assessment of cartilage repair: A report by the Histology Endpoint Committee of the International Cartilage Repair Society (ICRS).
        J Bone Joint Surg Am. 2003; 85: 45-57
        • Ding J.
        • Zhao J.
        • He Y.
        • Huangfu X.
        • Zeng B.
        Risk factors for articular cartilage lesions in symptomatic discoid lateral meniscus.
        Arthroscopy. 2009; 25: 1423-1426
        • Widuchowski W.
        • Widuchowski J.
        • Trzaska T.
        Articular cartilage defects: Study of 25,124 knee arthroscopies.
        Knee. 2007; 14: 177-182
        • Deie M.
        • Ochi M.
        • Sumen Y.
        • et al.
        Relationship between osteochondritis dissecans of the lateral femoral condyle and lateral menisci types.
        J Pediatr Orthop. 2006; 26: 79-82
        • Englund M.
        • Roos E.M.
        • Lohmander L.S.
        Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: A sixteen-year followup of meniscectomy with matched controls.
        Arthritis Rheum. 2003; 48: 2178-2187
        • Allen P.R.
        • Denham R.A.
        • Swan A.V.
        Late degenerative changes after meniscectomy. Factors affecting the knee after operation.
        J Bone Joint Surg Br. 1984; 66: 666-671
        • Lotke P.A.
        • Lefkoe R.T.
        • Ecker M.L.
        Late results following medial meniscectomy in an older population.
        J Bone Joint Surg Am. 1981; 63: 115-119
        • Roos H.
        • Adalberth T.
        • Dahlberg L.
        • Lohmander L.S.
        Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: The influence of time and age.
        Osteoarthritis Cartilage. 1995; 3: 261-267
        • Englund M.
        • Guermazi A.
        • Gale D.
        • et al.
        Incidental meniscal findings on knee MRI in middle-aged and elderly persons.
        N Engl J Med. 2008; 359: 1108-1115
        • Englund M.
        • Guermazi A.
        • Roemer F.W.
        • et al.
        Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: The Multicenter Osteoarthritis Study.
        Arthritis Rheum. 2009; 60: 831-839
        • Washington III, E.R.
        • Root L.
        • Liener U.C.
        Discoid lateral meniscus in children. Long-term follow-up after excision.
        J Bone Joint Surg Am. 1995; 77: 1357-1361
        • Curl W.W.
        • Krome J.
        • Gordon E.S.
        • Rushing J.
        • Smith B.P.
        • Poehling G.G.
        Cartilage injuries: A review of 31,516 knee arthroscopies.
        Arthroscopy. 1997; 13: 456-460
        • Jones S.
        • Caplan N.
        • St Clair Gibson A.
        • Kader N.
        • Kader D.
        Interactions between severity and location of chondral lesions and meniscal tears found at arthroscopy.
        Knee Surg Sports Traumatol Arthrosc. 2011; 19: 1699-1703
        • Yoshida S.
        • Ikata T.
        • Takai H.
        • Kashiwaguchi S.
        • Katoh S.
        • Takeda Y.
        Osteochondritis dissecans of the femoral condyle in the growth stage.
        Clin Orthop Relat Res. 1998; : 162-170
        • Kamei G.
        • Adachi N.
        • Deie M.
        • et al.
        Characteristic shape of the lateral femoral condyle in patients with osteochondritis dissecans accompanied by a discoid lateral meniscus.
        J Orthop Sci. 2012; 17: 124-128
        • Pena E.
        • Calvo B.
        • Martinez M.A.
        • Palanca D.
        • Doblare M.
        Finite element analysis of the effect of meniscal tears and meniscectomies on human knee biomechanics.
        Clin Biomech (Bristol, Avon). 2005; 20: 498-507
        • Wilson W.
        • van Rietbergen B.
        • van Donkelaar C.C.
        • Huiskes R.
        Pathways of load-induced cartilage damage causing cartilage degeneration in the knee after meniscectomy.
        J Biomech. 2003; 36: 845-851
        • Bai B.
        • Shun H.
        • Yin Z.X.
        • Liao Z.W.
        • Chen N.
        Changes of contact pressure and area in patellofemoral joint after different meniscectomies.
        Int Orthop. 2012; 36: 987-991
        • Papadopoulos A.
        • Kirkos J.M.
        • Kapetanos G.A.
        Histomorphologic study of discoid meniscus.
        Arthroscopy. 2009; 25: 262-268
        • Lankhorst N.E.
        • Bierma-Zeinstra S.M.
        • van Middelkoop M.
        Factors associated with patellofemoral pain syndrome: A systematic review.
        Br J Sports Med. 2013; 47: 193-206
        • Englund M.
        • Felson D.T.
        • Guermazi A.
        • et al.
        Risk factors for medial meniscal pathology on knee MRI in older US adults: A multicentre prospective cohort study.
        Ann Rheum Dis. 2011; 70: 1733-1739
        • Hunter D.J.
        • Zhang Y.Q.
        • Niu J.B.
        • et al.
        The association of meniscal pathologic changes with cartilage loss in symptomatic knee osteoarthritis.
        Arthritis Rheum. 2006; 54: 795-801
        • Eskelinen A.P.
        • Visuri T.
        • Larni H.M.
        • Ritsila V.
        Primary cartilage lesions of the knee joint in young male adults. Overweight as a predisposing factor. An arthroscopic study.
        Scand J Surg. 2004; 93: 229-233
        • Fok A.W.
        • Yau W.P.
        Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries.
        Knee Surg Sports Traumatol Arthrosc. 2013; 21: 928-933
        • Lawrence J.T.
        • Argawal N.
        • Ganley T.J.
        Degeneration of the knee joint in skeletally immature patients with a diagnosis of an anterior cruciate ligament tear: Is there harm in delay of treatment?.
        Am J Sports Med. 2011; 39: 2582-2587
        • Murrell G.A.
        • Maddali S.
        • Horovitz L.
        • Oakley S.P.
        • Warren R.F.
        The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss.
        Am J Sports Med. 2001; 29: 9-14
        • Carter C.W.
        • Hoellwarth J.
        • Weiss J.M.
        Clinical outcomes as a function of meniscal stability in the discoid meniscus: A preliminary report.
        J Pediatr Orthop. 2012; 32: 9-14
        • Forkel P.
        • Herbort M.
        • Schulze M.
        • et al.
        Biomechanical consequences of a posterior root tear of the lateral meniscus: Stabilizing effect of the meniscofemoral ligament.
        Arch Orthop Trauma Surg. 2013; 133: 621-626