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Symptomatic discoid lateral meniscus shows a relationship between types and tear patterns, and between causes of clinical symptom onset and the age distribution

Abstract

Purpose

Discoid meniscus is a congenital abnormality of the lateral meniscus and is seen more frequently in East Asia. The purpose of this study was to retrospectively assess the relationship between discoid lateral meniscus (DLM) types and tear patterns and causes of age-specific clinical symptom onset.

Methods

Of 1650 arthroscopic surgeries over a 20-year period, 138 (105 patients) were performed for DLM and were evaluated in this study. The mean age at surgery was 21.5 ± 15.8 years. The DLM type was classified by Watanabe’s classification, and tear patterns were classified by the modified Bin’s classification as simple horizontal, complicated horizontal, longitudinal, radial, complex, and no tear. Additionally, patients were divided by age group (< 10, 10–19, 20–39, 40–59, and ≥ 60 years) and classified according to the causes of clinical symptom onset as follows: sports activities, minor trauma in daily living, and no traumatic episode.

Results

The DLM was complete in 78 (56.5%) knees and incomplete in 60 (43.5%); no Wrisberg type DLM was observed. Simple horizontal and complicated horizontal tears were significantly more frequent in complete DLM, whereas radial tears and no tears were significantly more frequent in incomplete DLM (p < 0.0001). When classified by age group, 74 (53.6%) knees with DLMs were found in teenagers. Sports activities caused symptom onset significantly more often in teenagers, no traumatic episode caused symptom onset in patients aged < 10 years, and minor trauma in daily living caused symptom onset in patients aged 40–59 years and ≥ 60 years (p < 0.0001). No relationship was found between the age distribution and tear patterns; however, the absence of tears tended to be more common in teenaged patients, and complicated horizontal tears were more common in patients over 20 years of age.

Conclusion

Symptomatic DLM occurred most often in teenagers. A relationship was identified between the DLM types and tear patterns, which could be helpful in preoperative planning. Causes of clinical symptom onset in patients with DLM were characterised by age group, which might help clinicians to suspect the presence of DLM.

Level of evidence

Level IV.

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Fig. 1
Fig. 2

Abbreviations

DLM:

Discoid lateral meniscus

MRI:

Magnetic resonance imaging

n.s.:

Not significant

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Funding

This study was supported by a Grant-in-Aid for Clinical Research from Miyazaki University Hospital.

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Authors

Contributions

NY wrote, reviewed, and revised the manuscript. NY, TT, YM, and TY performed the surgery, collected clinical data, and were responsible for postoperative follow-up. All authors have reviewed and approved the manuscript.

Corresponding author

Correspondence to Nami Yamaguchi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the review board of Faculty of Medicine, University of Miyazaki (No. O-0773). Information regarding the study protocol was disclosed prior to the study.

Informed consent

Information regarding the protocol of this study was disclosed at HP of the Faculty of Medicine, University of Miyazaki, and research subjects were provided an opportunity to refuse inclusion in this study. Patients who did not want to take part were not enrolled in this study.

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Yamaguchi, N., Chosa, E., Tajima, T. et al. Symptomatic discoid lateral meniscus shows a relationship between types and tear patterns, and between causes of clinical symptom onset and the age distribution. Knee Surg Sports Traumatol Arthrosc (2021). https://doi.org/10.1007/s00167-021-06635-3

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Keywords

  • Discoid lateral meniscus
  • Type
  • Tear pattern
  • Clinical symptom onset
  • Age distribution