Advertisement

Morphological structure and variations of fetal lateral meniscus: the significance in convenient diagnosis and treatment

  • Anıl Didem Aydın KabakçıEmail author
  • Mustafa Büyükmumcu
  • Duygu Akın
  • Onur Bilge
KNEE
  • 37 Downloads

Abstract

Purpose

The aim of this study is to evaluate of morphometry of the lateral meniscus (LM) and determine incidence of the LM shapes.

Methods

This study was performed on fetal cadaver collection of Anatomy Department of Necmettin Erbakan University. Fifty human fetal cadavers (25 female, 25 male human fetal cadavers) were used in this study. Microdissection was performed. Morphometric measurements were performed. LM were classified into four types and five subtypes.

Results

In this study, it was identified that all parameters which were measured were found to be increased with gestational ages. Four morphological types and five morphological subtypes were determined. It was found that 12% of the LM were crescent-shaped, 66% of the LM were C-shaped, 14% of the LM were incomplete-disc-shaped, 2% of the LM were disc-shaped, 6% of the LM were variant C-shaped.

Conclusions

A few studies on fetal meniscal anatomy and its development were performed. Each new study is important for having detailed anatomy and development of the fetal menisci which will have both clinical and anatomical impacts during childhood and adulthood for orthopedic surgeons and anatomists, respectively. The most important results of this study were the detailed objective analysis of the macroscopic fetal growth of LM. It was significantly observed that four morphological types and five morphological subtypes of LM. The results of the present study related with both the observation of morphological development of the fetal meniscal anatomy, and its morphological variants, are important in terms of improving our knowledge, and clinical approach on the description, and the management of the symptomatic lateral discoid meniscus tears in children, adolescents, and adults. The clinical relevance of this study was that this classification of fetal menisci could ameliorate our current understanding of the morphology of lateral meniscus in adult, further.

Keywords

Lateral meniscus Fetal cadavers Morphometry 

Notes

Acknowledgements

We thank the fetal cadaver donors for contribution to study.

Author contributions

All authors have participated in conception and design, or analysis and interpretation of the data; drafting the article or revising it critically for important intellectual content; and approval of the final version.

Funding

The authors have no affiliation with any organization with a direct or indirect financial interest in the subject matter discussed in the manuscript.

Compliance with ethical standards

Conflict of interest

The research was not sponsored by an outside organization. We (all of the authors) have agreed to allow full access to the primary data and to allow the journal to review the data if requested. There is no conflict of interest between the authors and this manuscript has not been submitted to, nor is under review at, another journal or other publishing venue.

Ethical review committee statement

This study conformed to the Helsinki Declaration.

References

  1. 1.
    Arnold MP, Van Kampen A (2000) Symptomatic ring-shaped lateral meniscus. Arthroscopy 16:852–854CrossRefGoogle Scholar
  2. 2.
    Baratz ME, Fu FH, Mengato R (1986) Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee: a preliminary report. Am J Sports Med 14:270–275CrossRefGoogle Scholar
  3. 3.
    Braz P, Silva W (2010) Meniscus morphometric study in humans. J Morphol Sci 27:62–66Google Scholar
  4. 4.
    Clark C, Ogden J (1983) Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am 65:538–547CrossRefGoogle Scholar
  5. 5.
    Dhananjaya KVN, Murlimanju BV, Poornima V et al (2014) In vivo morphometry of menisci of the knee in South Indians: a preliminary study. Biomed J 37:14CrossRefGoogle Scholar
  6. 6.
    Ellis HB Jr, Wise K, LaMont L et al (2017) Prevalence of discoid meniscus during arthroscopy for isolated lateral meniscal pathology in the pediatric population. J Pediatr Orthoped 37:285–292CrossRefGoogle Scholar
  7. 7.
    Fukazawa I, Hatta T, Uchio Y et al (2009) Development of the meniscus of the knee joint in human fetuses. Congenit Anom 49:27–32CrossRefGoogle Scholar
  8. 8.
    Gohiya V, Pandey R (2014) Morphometric study of the menisci of knee joints of human fetuses. Int J Med Sci Public Health 3(1):38–41CrossRefGoogle Scholar
  9. 9.
    Goyal N, Aggarwal N, Kaushal S et al (2016) Morphometry of lateral meniscus: a cadaveric study. Int J Anat Res 4:3179–3184CrossRefGoogle Scholar
  10. 10.
    Hensinger RN (1992) Standarts and measurements: fetus and neonate. In: Polin RA, Fox WW(eds) Detal and neonatal physiology. W.B. Saunders Co., Philadelphia, pp 1687–1696Google Scholar
  11. 11.
    Hwang SH, Jung K-A, Lee WJ et al (2012) Morphological changes of the lateral meniscus in end-stage lateral compartment osteoarthritis of the knee. Osteoarthr Cartil 20:110–116CrossRefGoogle Scholar
  12. 12.
    Jiang W, Li X, Su H et al (2016) A new method to diagnose discoid lateral menisci on radiographs. Knee Surg Sports Traumatol Arthrosc 24:1519–1524CrossRefGoogle Scholar
  13. 13.
    Kale A, Kopuz C, Edizer M et al (2006) Anatomic variations of the shape of the menisci: a neonatal cadaver study. Knee Surg Sports Traumatol Arthrosc 14:975–981CrossRefGoogle Scholar
  14. 14.
    Kaplan E (1957) Discoid lateral meniscus of the knee joint. J Bone Joint Surg 39:77–87CrossRefGoogle Scholar
  15. 15.
    Kim S-J, Lee Y-T, Choi C-H et al (1998) A partially duplicated discoid lateral meniscus. Arthroscopy 14:518–521CrossRefGoogle Scholar
  16. 16.
    Kocher MS, Klingele K, Rassman SO (2003) Meniscal disorders: normal, discoid, and cysts. Orthop Clin N Am 34:329–340CrossRefGoogle Scholar
  17. 17.
    Kotrappa VI (2014) Morphometric analysis of menisci of the knee joint in adult human cadavers of north Karnataka—a cross sectional study, Doctoral dissertation. KLE University, BelgaumGoogle Scholar
  18. 18.
    Koyuncu E, Özgüner G, Öztürk K et al (2017) The morphological anatomy of the menisci of the knee joint in human fetuses. Balkan Med J 34(6):559–566CrossRefGoogle Scholar
  19. 19.
    Le Minor J (1990) Comparative morphology of the lateral meniscus of the knee in primates. J Anat 170:161–171Google Scholar
  20. 20.
    Makris EA, Hadidi P, Athanasiou KA (2011) The knee meniscus: structure–function, pathophysiology, current repair techniques, and prospects for regeneration. Biomaterials 32:7411–7431CrossRefGoogle Scholar
  21. 21.
    Messner K, Gao J (1998) The menisci of the knee joint. Anatomical and functional characteristics, and a rationale for clinical treatment. J Anat 193:161–178CrossRefGoogle Scholar
  22. 22.
    Murlimanju B, Nair N, Pai S et al (2010) Morphological study of the menisci of the knee joint in adult cadavers of the South Indian population. MMJ 23(2):270–275Google Scholar
  23. 23.
    Murlimanju B, Nair N, Pai SR et al (2010) Morphometric analysis of the menisci of the knee joint in South Indian human fetuses. Int J Morphol 28:1167–1171CrossRefGoogle Scholar
  24. 24.
    Murlimanju B, Nair N, Pai SR et al (2011) Bilateral incomplete discoid lateral meniscus in a 14 weeks fetus: a case report and review of literature. Rom J Morphol Embryol 52:729–731Google Scholar
  25. 25.
    Murlimanju B, Nair N, Ray B et al (2011) Morphological variants of lateral meniscus of the knee: a cadaveric study in South Indian human fetuses. Anat Scı Int 86:63–68CrossRefGoogle Scholar
  26. 26.
    Murlimanju B, Narga N, Kumar V (2010) Complete lateral discoid meniscus in a South Indian fetus: a case report and review of literatureThe medial menisci in both the knee joints of the fetus were having. IJAV 3:110–111Google Scholar
  27. 27.
    Ozcanli H, Keles N, Gocmen-Mas N et al (2011) Relation of discoid lateral meniscus and cord-like anterior intermeniscal ligament: morphological and clinical study. SRA 33:673–678Google Scholar
  28. 28.
    Poulsen MR, Johnson DL (2011) Meniscal injuries in the young, athletically active patient. Phys Sportsmed 39:123–130CrossRefGoogle Scholar
  29. 29.
    Rashmi B, Dakshayani K, Vadiraja N (2016) Morphometric study of menisci of knee joints in adult cadavers. Int J Anat Res 4:2973–2978CrossRefGoogle Scholar
  30. 30.
    Rohila J, Rathee SK, Dhattarwal SK et al (2017) Morphometric analysis of menisci of adult human knee joint in North Indian population. J Res Med Sci 5:569–573Google Scholar
  31. 31.
    Ryu K, Iriuchishima T, Oshida M et al (2015) Evaluation of the morphological variations of the meniscus: a cadaver study. Knee Surg Sport Traumatol Arthrosc 23:15–19CrossRefGoogle Scholar
  32. 32.
    Sarwar MY, Kumar N, Yasmin T (2016) Morphological study of the menisci of the knee joint in adult cadavers of North Indian population. Int J Life Sci Sci Res 2(5):619–622Google Scholar
  33. 33.
    Simão MN, Nogueira-Barbosa MH (2011) Magnetic resonance imaging in the assessment of meniscal anatomic variants and of the perimeniscal ligamentous anatomy: potential interpretation pitfalls. Radiol Bras 44:117–122CrossRefGoogle Scholar
  34. 34.
    Smillie I (1948) The congenital discoid meniscus. Bone Joint J 30:671–682Google Scholar
  35. 35.
    Suzuki S, Mita F, Ogishima H (1991) Double-layered lateral meniscus: a newly found anomaly. Arthroscopy 7:267–271CrossRefGoogle Scholar
  36. 36.
    Takroni T, Laouar L, Adesida A et al (2016) Anatomical study: comparing the human, sheep and pig knee meniscus. J Exp Orthop 3(35):2–13Google Scholar
  37. 37.
    Tena-Arregui J, Barrio-Asensio C, Viejo-Tirado F et al (2003) Arthroscopic study of the knee joint in fetuses. Arthroscopy 19:862–868CrossRefGoogle Scholar
  38. 38.
    Wang Q, Liu X-m, Liu S-b et al (2011) Double-layered lateral meniscus. Knee Surg Sport Traumatol Arthrosc 19:2050–2051CrossRefGoogle Scholar
  39. 39.
    Zhang KY, Kedgley AE, Donoghue CR et al (2014) The relationship between lateral meniscus shape and joint contact parameters in the knee: a study using data from the Osteoarthritis Initiative. Arthritis Res Ther 16:R27CrossRefGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Department of Anatomy, Meram Faculty of MedicineUniversity of Necmettin ErbakanKonyaTurkey
  2. 2.Department of Orthopaedics and Traumatology, Meram Faculty of MedicineUniversity of Necmettin ErbakanKonyaTurkey
  3. 3.Department of Sports Medicine, Meram Faculty of MedicineUniversity of Necmettin ErbakanKonyaTurkey

Personalised recommendations