Advertisement

An arthroscopic analysis of lateral meniscal variants and a comparison with MRI findings

  • Yong-Goo Kim
  • Joo-Chul Ihn
  • Seong-Ki Park
  • Hee-Soo KyungEmail author
Knee

Abstract

We reviewed 164 consecutive cases (158 patients) of arthroscopic examinations for lateral meniscal variants during the last 10 years. We classified lateral meniscal variants into four types by arthroscopic appearance, into six tear patterns by modifying O’Connor’s classification, and compared magnetic resonance images (MRI) with arthroscopic findings. Regarding the four types, 131 cases were complete, 25 cases were incomplete, 4 cases were Wrisberg, and 4 cases were ring-shaped meniscus. The six tear patterns were as follows: 33 simple horizontal, 21 combined horizontal, 37 longitudinal, 27 central, 14 complex, and 12 radial tear. Among the 31 knees with a central tear or ring-shaped meniscus, we reviewed 25 MR images. Fifteen (60%) MRI findings were interpreted to represent a bucket-handle (displaced) tear of the normal C-shaped meniscus; 7(28%) MRI findings, a discoid meniscal tear; and the remaining 3(12%) MRI findings, a simple meniscal tear. Moreover, all ring-shaped menisci were interpreted as a displaced lateral meniscal tear on the MRI findings. Twelve patients (13 knees, 7.9%) had osteochondritis dissecans: Nine patients (10 knees) of them had a central tear, two patients (2 knees) of them had a simple horizontal tear of the discoid meniscus, and one patient (1 knee) had a ring-shaped meniscus. Twenty three patients (92.6%) with a central tear of the discoid meniscus did not have any traumatic events. For the differential diagnosis of a central tear or a ring-shaped meniscus from a bucket-handle tear of the normal C-shaped meniscus, we should take a careful history, in particular any traumatic events, we should also consider the possibility of misinterpreting the MR images though these images can provide additional information about associated abnormalities and probe carefully in the arthroscopic operations.

Keywords

Discoid meniscus Arthroscopic classification 

References

  1. 1.
    Aichroth PM, Patel DV, Marx CL (1991) Congenital discoid lateral meniscus in children. A follow-up study and evolution of management. J Bone Joint Surg Br 73:932–936PubMedGoogle Scholar
  2. 2.
    Bellier G, Dupont JY, Larrain M, Caudron C, Carlioz H (1989) Lateral discoid menisci in children. Arthroscopy 5:52–56PubMedGoogle Scholar
  3. 3.
    Bin SI, Kim JC, Kim JM, Park SS, Han YK (2002) Correlation between type of discoid lateral menisci and tear pattern. Knee Surg Sports Traumatol Arthrosc 10:218–222CrossRefPubMedGoogle Scholar
  4. 4.
    Dickhaut SC, DeLee JC (1982) The discoid lateral-meniscus syndrome. J Bone Joint Surg Am 64:1068–1073PubMedGoogle Scholar
  5. 5.
    Fujikawa K, Iseki F, Mikura Y (1981) Partial resection of the discoid meniscus in the child’s knee. J Bone Joint Surg Br 63:391–395Google Scholar
  6. 6.
    Hayashi LK, Yamaga H, Ida K, Miura T (1988) Arthroscopic meniscectomy for discoid lateral meniscus in children. J Bone Joint Surg Am 70:1495–1500PubMedGoogle Scholar
  7. 7.
    Hong CN (1999) A ring-shaped lateral meniscus. Am J Knee Surg 12:109–110PubMedGoogle Scholar
  8. 8.
    Ikeuchi H (1982) Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results. Clin Orthop Relat Res 167:19–28PubMedGoogle Scholar
  9. 9.
    Irani RN, Karasick D, Karasick S (1984) A possible explanation of the pathogenesis of osteochondritis dissecans. J Pediatr Orthop 4:358–360PubMedGoogle Scholar
  10. 10.
    Kaplan EB (1957) Discoid lateral meniscus of the knee joint: nature, mechanism and operative treatment. J Bone Joint Surg Am 39:77–87Google Scholar
  11. 11.
    Kim SJ, Jeon CH, Koh CH (1995) A ring-shaped lateral meniscus. Arthroscopy 11:738–739PubMedGoogle Scholar
  12. 12.
    Middleton DS (1936) Congenital disc-shaped lateral meniscus with snapping knee. Br J Surg 24:246–255Google Scholar
  13. 13.
    Mitsuoka T, Shino K, Hamada M, Horibe S (1999) Osteochondritis dissecans of the lateral femoral condyle of the knee joint. Arthroscopy 15:20–26PubMedGoogle Scholar
  14. 14.
    Monllau JC, Leon A, Cugat R, Ballester J (1998) Ring-shaped lateral meniscus. Arthroscopy 14:502–504PubMedGoogle Scholar
  15. 15.
    Nathan PA, Cole SC (1969) Discoid meniscus. A clinical and pathologic study. Clin Orthop 64:107–113PubMedGoogle Scholar
  16. 16.
    Neuschwander DC, Drez D Jr, Finney TP (1992) Lateral meniscal variant with absence of the posterior coronary ligament. J Bone Joint Surg Am 74:1186–1190PubMedGoogle Scholar
  17. 17.
    Noble J (1975) Congenital absence of the anterior cruciate ligament associated with a ring meniscus. J Bone Joint Surg Am 57:1165–1156PubMedGoogle Scholar
  18. 18.
    Seong SC, Park MJ (1992) Analysis of the discoid meniscus in Koreans. Orthopedics 15:61–65PubMedGoogle Scholar
  19. 19.
    Shahriaree H (1992) O’Conner’s textbook of arthroscopic surgery. Lippincott, Philadelphia, pp 318–321Google Scholar
  20. 20.
    Silverman JM, Mink JH, Deutsch AL (1989) Discoid menisci of the knee: MR imaging appearance. Radiology 173:351–354PubMedGoogle Scholar
  21. 21.
    Smillie IS (1948) The congenital discoid meniscus. J Bone Joint Surg Br 30:671–682Google Scholar
  22. 22.
    Vandermeer RD, Cunningham FK (1989) Arthroscopic treatment of the discoid lateral meniscus: results of long-term follow-up. Arthroscopy 5:101–109PubMedGoogle Scholar
  23. 23.
    Wadanabe M, Takeda S, Ikeuchi H (1974) Atlas of arthroscopy, 3rd edn. Igaku Shoin, Tokyo, pp 87–91Google Scholar
  24. 24.
    Washington ER III, Root L, Liener UC (1995) Discoid lateral meniscus in children. Long-term follow-up after excision. J Bone Joint Surg Am 77:1357–1361PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Yong-Goo Kim
    • 1
  • Joo-Chul Ihn
    • 1
  • Seong-Ki Park
    • 1
  • Hee-Soo Kyung
    • 1
    Email author
  1. 1.Department of Orthopaedic Surgery, School of MedicineKyungpook National UniversityDaeguKorea

Personalised recommendations