Abstract
Purpose
To evaluate the clinical manifestations and the outcome of surgical treatment of discoid medial meniscus.
Methods
Records of 13 patients with discoid medial meniscus were retrospectively reviewed for their epidemiology, clinical manifestations, operation methods, treatment outcome and radiographic characteristics.
Results
The 13 cases of discoid medial meniscal injury took up 1.5 ‰ of the overall meniscal injuries treated at our institute during the 44-year period. Patients presented with knee pain (13 patients), giving away (10 patients), swelling (9 patients) and snapping (9 patients). The most common physical signs were medial joint line tenderness (13 patients) and positive McMurray test (11 patients). Ten patients required total meniscectomy. There were excellent short-term results: the median Tegner score was 7, and the mean Lysholm score was 94.8 ± 2.4 at two-year follow-up. However, the long-term outcome was not as good with degenerative changes in the medial compartment of all the involved knees.
Conclusion
The discoid medial meniscus is extremely rare. The clinical signs and symptoms of discoid medial meniscal injuries are similar to those of any other meniscal injury. No Wrisberg-ligament type abnormality was found. Meniscectomy for discoid medial meniscus produced promising short-term results and deteriorating long-term results with secondary degeneration of cartilage in the medial compartment.
Level of evidence
Retrospective case series, Level IV.
Similar content being viewed by others
References
Adachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R (2004) Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear. Arthroscopy 20:536–542
Ahn JH, Lee SH, Yoo JC, Lee YS, Ha CH (2008) Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up. Arthroscopy 24:888–898
Aichroth PM, Patel DV, Marx CL (1991) Congenital discoid lateral meniscus in children. A follow-up study and evolution of management. J Bone Jt Surg Br 73:932–936
Cave EF, Staples OS (1941) Congenital discoid meniscus. A cause of internal derangement of the knee. Am J Surg 54:371–376
Dickason JM, Del Pizzo W, Blazina ME, Fox JM, Friedman MJ, Snyder SJ (1982) A series of ten discoid medial menisci. Clin Orthop Relat Res 168:75–79
Dickhaut SC, DeLee JC (1982) The discoid latreral meniscus syndrome. J Bone Jt Surg Am 64:1068–1073
Elvey MH, Konan S, House CV, Patel RV (2011) Horizontal cleavage tear of discoid medial meniscus diagnosed on MRI and treated with arthroscopic partial resection. Knee Surg Sports Traumatol Arthrosc 19:1860–1867
Fujikawa K, Iseki F, Mikura Y (1981) Partial resection of the discoid meniscus in the child’s knee. J Bone Jt Surg Br 63:391–395
Hayashi LK, Yamaga H, Ida H, Miura T (1988) Arthroscopic meniscectomy for discoid lateral meniscus in children. J Bone Jt Surg Am 70:1495–1500
Jeannopoulos CL (1950) Observations on discoid menisci. J Bone Jt Surg Am 32:649–652
Johnson RG, Simmons EH (1982) Discoid medial meniscus. Clin Orthop Relat Res 167:176–179
Kaplan EB (1957) Discoid lateral meniscus of the knee joint: nature, mechanism, and operative treatment. J Bone Jt Surg Am 39:77–87
Kramer DE, Micheli LJ (2009) Meniscal tears and discoid meniscus in children: diagnosis and treatment. J Am Acad Orthop Surg 17:698–707
Li X, Benjamin Ma C, Link TM, Castillo DD, Blumenkrantz G, Lozano J, Carballido-Gamio J, Ries M, Majumdar S (2007) In vivo T(1rho) and T(2) mapping of articular cartilage in osteoarthritis of the knee using 3 T MRI. Osteoarthr Cartil 15:789–797
Mayer-Wagner S, Von Liebe A, Horng A, Scharpf A, Vogel T, Mayer W, Jansson V, Glaser C, Müller PE (2011) Discoid lateral meniscus in children: magnetic resonance imaging after arthroscopic resection. Knee Surg Sports Traumatol Arthrosc 19:1920–1924
Middleton DS (1936) Congenital disc-shaped lateral meniscus with snapping knee. Br J Surg 24:246–255
Papadopoulos A, Karathanasis A, Kirkos JM, Kapetanos GA (2009) Epidemiologic, clinical and arthroscopic study of the discoid meniscus variant in Greek population. Knee Surg Sports Traumatol Arthrosc 17:600–606
Pellacci F, Montanari G, Prosperi P, Galli G, Celli V (1992) Lateral discoid meniscus: treatment and results. Arthroscopy 8:526–530
Raber DA, Friederich NF, Hefti F (1998) Discoid lateral meniscus in children. Long-term follow-up after total meniscectomy. J Bone Jt Surg Am 80:1579–1586
Smillie IS (1978) Injuries of the knee joint, 5th edn. Churchill Livingstone, Edinburgh, pp 98–103
Smillie IS (1948) The congenital discoid meniscus. J Bone Jt Surg Br 30:671–682
Vahvanen V, Aalto K (1979) Meniscectomy in children. Acta Orthop Scand 50:791–795
Wang YJ, Yu JK, Luo H, Yu CL, Ao YF, Xie X, Jiang D, Zhang JY (2009) An anatomical and histological study of human meniscal horn bony insertions and peri-meniscal attachments as a basis for meniscal transplantation. Chin Med J 122:536–540
Washington ER, Root L, Liener UC (1995) Discoid lateral meniscus in children. Long-term follow-up after excision. J Bone Jt Surg Am 77:1357–1361
Watanabe M (1974) Arthroscopy of the knee joint. In: Helfet AJ (ed) Disorders of the knee. Lippincott, Philadelphia, p 45
Watson-Jones R (1930) Specimen of internal semilunar cartilage as a complete disc. Proc R Soc Med 23:1588–1589
Weiner B, Rosenberg N (1974) Discoid medial meniscus: association with bone changes in the tibia. J Bone Jt Surg Am 56:171–173
Young RB (1889) The external semilunar cartilage as a complete disc. In: Cleland J, MacKay JY, Young RB (eds) Memoirs and Memoranda in anatomy. Williams and Norgata, London, p 179
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chen, LX., Ao, YF., Yu, JK. et al. Clinical features and prognosis of discoid medial meniscus. Knee Surg Sports Traumatol Arthrosc 21, 398–402 (2013). https://doi.org/10.1007/s00167-012-1979-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-012-1979-5