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Midbody of the medial meniscus as a reference of preservation in partial meniscectomy for complete discoid lateral meniscus

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate the postoperative size of discoid lateral meniscus using magnetic resonance imaging (MRI) after partial meniscectomy relative to the size of medial meniscus midbody.

Methods

This study included 48 patients who underwent arthroscopic partial meniscectomy with or without repair for symptomatic complete discoid meniscus. The intraoperative size of midbody of medial meniscus was used as a reference for partial meniscectomy. MRIs were performed pre- and postoperatively. Quantitative evaluations of the height, width, extrusion of the meniscus, and relative percentage of extrusion in the coronal and sagittal planes were completed. Demographic data, preoperative shift, type of shift, and operative technique were analyzed while considering the remaining meniscus. Logistic regression analyses were used.

Results

The mean remaining discoid meniscal width in the coronal plane of MRI was not significantly different from the width of midbody of medial meniscus (9.1 ± 4.2 mm vs. 9.4 ± 1.4 mm, n.s.) Absolute meniscal extrusion and relative percentage of extrusion in the coronal plane and the ratio of t meniscus in sagittal plane of the final MRI were significantly increased as compared with the preoperative MRI. Preoperative shift was a risk factor for the reduction of remaining meniscal width (odds ratio 11.997, p = 0.016, 95% CI 1.586–90.737).

Conclusion

The size of midbody of medial meniscus could be a reference for partial meniscectomy in symptomatic complete discoid meniscus. Preoperative shift represents a risk factor for decreased remaining meniscal width. These findings could be helpful in ensuring appropriate surgical planning and explaining poor prognostic factors.

Level of evidence

Prospective cohort study, Level II.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Chung-Ang University Hospital, Seoul, South Korea

    Seong Hwan Kim

  2. Department of Orthopedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, South Korea

    JungTae Ahn, Tae Wook Kim, Kang-Il Kim & Sang Hak Lee

  3. Orthopedic Department, Centre Hospitalier de Versailles, Le Chesnay, France

    Seong Hwan Kim

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Correspondence to Sang Hak Lee.

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Ethical approval

This is approved by the institutional review board of Kyung Hee University Hospital at Gangdong (Institutional Review Board/protocol number, KHNMC2013-01-047.) and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Kim, S.H., Ahn, J., Kim, T.W. et al. Midbody of the medial meniscus as a reference of preservation in partial meniscectomy for complete discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 27, 2558–2567 (2019). https://doi.org/10.1007/s00167-018-5268-9

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  • DOI: https://doi.org/10.1007/s00167-018-5268-9

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