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Torn discoid lateral meniscus is associated with increased medial meniscal extrusion and worse articular cartilage status in older patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare the clinical, imaging, and arthroscopic characteristics of the torn discoid lateral meniscus (TDLM) in patients greater than 40 years of age with matched controls.

Methods

One hundred and ninety-four older patients (211 knees) who underwent arthroscopic surgery for a TDLM were consecutively recruited (Group 1). Another 211 age- and sex-matched controls with a torn semilunar lateral meniscus were included in this study (Group 2). Statistical analyses were used to determine the differences in the clinical, imaging, and arthroscopic characteristics between the two groups.

Results

In our series, more severe medial meniscal extrusion on magnetic resonance imaging was present in Group 1 than in Group 2 and more serious osteoarthritic changes were observed in both the medial and lateral compartments in Group 1. Under the same conditions, chondral lesions in the knee were more serious in Group 1 than in Group 2 when patients were subgrouped according to the presence of a horizontal tear or complex tear.

Conclusions

In the present study, older patients with a torn discoid lateral meniscus exhibited greater and more severe medial meniscal extrusion and more serious osteoarthritis. Therefore, knees with a discoid lateral meniscus displaying medial meniscal extrusion should be monitored carefully with long-term follow-up, because a medial meniscal extrusion may increase the risk of progression to degenerative osteoarthritis of the medial compartment. Regarding the clinical relevance, these findings will be helpful in further revealing that a torn discoid lateral meniscus may affect not only the cartilage in the lateral compartment but also the cartilage in the medial compartment and medial meniscal extrusion.

Level of evidence

III.

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References

  1. Adams JG, McAlindon T, Dimasi M, Carey J, Eustace S (1999) Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis. Clin Radiol 54:502–506

    Article  CAS  PubMed  Google Scholar 

  2. Ahn JH, Choi SH, Lee YS, Yoo JC, Chang MJ, Bae S, Bae YR (2011) Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 19:158–164

    Article  PubMed  Google Scholar 

  3. Ahn JH, Shim JS, Hwang CH, Oh WH (2001) Discoid lateral meniscus in children: clinical manifestations and morphology. J Pediatr Orthop 21:812–816

    CAS  PubMed  Google Scholar 

  4. Atay OA, Pekmezci M, Doral MN, Sargon MF, Ayvaz M, Johnson DL (2007) Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med 35:475–478

    Article  PubMed  Google Scholar 

  5. Brittberg M, Winalski CS (2003) Evaluation of cartilage injuries and repair. J Bone Jt Surg Am 2:58–69

    Article  Google Scholar 

  6. Chen LX, Ao YF, Yu JK, Miao Y, Leung KK, Wang HJ, Lin L (2013) Clinical features and prognosis of discoid medial meniscus. Knee Surg Sports Traumatol Arthrosc 21:398–402

    Article  PubMed  Google Scholar 

  7. Choi SH, Ahn JH, Kim KI, Ji SK, Kang SM, Kim JS, Lee SH (2015) Do the radiographic findings of symptomatic discoid lateral meniscus in children differ from normal control subjects? Knee Surg Sports Traumatol Arthrosc 23:1128–1134

    Article  PubMed  Google Scholar 

  8. Christoforakis J, Pradhan R, Sanchez-Ballester J, Hunt N, Strachan RK (2005) Is there an association between articular cartilage changes and degenerative meniscus Tears? Arthroscopy 21:1366–1369

    Article  PubMed  Google Scholar 

  9. Ding J, Zhao JH, He YH, Huangfu XQ, Zeng BF (2013) Risk factors for articular cartilage lesions in symptomatic discoid lateral meniscus. Arthroscopy 25:1423–1426

    Article  Google Scholar 

  10. Englund M, Roos EM, Lohmander LS (2003) Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. Arthritis Rheum 48:2178–2187

    Article  CAS  PubMed  Google Scholar 

  11. Fu D, Guo L, Yang L, Chen G, Duan X (2014) Discoid lateral meniscus tears and concomitant articular cartilage lesions in the knee. Arthroscopy 30:311–318

    Article  PubMed  Google Scholar 

  12. Gicquel P, Sorriaux G, Clavert JM, Bonnomet F (2005) Discoid menisci in children: clinical patterns and treatment in eighteen knees. Rev Chir Orthop 91:457–464

    CAS  PubMed  Google Scholar 

  13. Jung JY, Choi SH, Ahn JH, Lee SA (2013) MRI findings with arthroscopic correlation for tear of discoid lateral meniscus: comparison between children and adults. Acta Radiol 54:442–447

    Article  PubMed  Google Scholar 

  14. Kelly BT, Green DW (2002) Discoid lateral meniscus in children. Curr Opin Pediatr 14:54–61

    Article  PubMed  Google Scholar 

  15. Kim SJ, Bae JH, Lim HC (2013) Does torn discoid meniscus have effects on limb alignment and arthritic change in middle-aged patients? J Bone Jt Surg Am 95:2008–2014

    Article  Google Scholar 

  16. Kim SJ, Choi CH (1996) Bilateral complete discoid medial menisci combined with anomalous insertion and cyst formation. Arthroscopy 12:112–115

    Article  CAS  PubMed  Google Scholar 

  17. Kim SJ, Lee YT, Kim DW (1998) Intraarticular anatomic variants associated with discoid meniscus in Koreans. Clin Orthop Relat Res 356:202–207

    Article  Google Scholar 

  18. Lee CR, Bin SI, Kim JM, Lee BS, Kim NK (2017) Arthroscopic partial meniscectomy in young patients with symptomatic discoid lateral meniscus: an average 10-year follow-up study. Arch Orthop Trauma Surg 138(3):369–376

    Article  PubMed  Google Scholar 

  19. Lee DH, Kim TH, Kim JM, Bin SI (2009) Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Arthroscopy 25(05):496–503

    Article  PubMed  Google Scholar 

  20. Levine M, Ensom MH (2001) Post hoc power analysis: an idea whose time has passed? Pharmacotherapy 21:405–409

    Article  CAS  PubMed  Google Scholar 

  21. Lu Y, Liu F-q, Meng H (2013) Bilateral complete type discoid medial menisci: an adult patient with tears in both knees. Chin Med J (Engl) 126:2587–2588

    Google Scholar 

  22. Min B-H, Ha HK, Khang SY (2001) Medial discoid meniscus completely coalesced with the anterior cruciate ligament. Arthroscopy 17:1–5

    Article  Google Scholar 

  23. Nawata K, Teshima R, Ohno M, Takita T, Otuki K (1999) Discoid lateral menisci in older patients—a radiographic study of 21 cases. Int Orthop 23:232–235

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Ogut T, Kesmezacar H, Akgun I, Cansu E (2003) Arthroscopic meniscectomy for discoid lateral meniscus in children and adolescents: 4.5 year follow-up. J Pediatr Orthop 12:390–397

    Article  Google Scholar 

  25. Rao PS, Rao SK, Paul R (2001) Clinical, radiologic, and arthroscopic assessment of discoid lateral meniscus. Arthroscopy 17:275–277

    Article  PubMed  Google Scholar 

  26. Song JG, Han JH, Kwon JH, Shetty GM, Franco LA, Kwon DY, Nha KW (2015) Radiographic evaluation of complete and incomplete discoid lateral meniscus. Knee 22:163–168

    Article  PubMed  Google Scholar 

  27. Walker PS, Erkman MJ (1975) The role of the menisci in force transmission across the knee. Clin Orthop Relat Res 184–192

  28. 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

    Article  Google Scholar 

  29. Watanabe M, Takeda S, Ikeuchi H (1979) Atlas of arthroscopy. Springer, New York

    Google Scholar 

  30. Wong T, Wang CJ (2011) Functional analysis on the treatment of torn discoid lateral meniscus. Knee 18:369–372

    Article  PubMed  Google Scholar 

  31. Xu ZH, Chen DY, Shi DQ, Dai J, Yao Y, Jiang Q (2016) Evaluation of posterior lateral femoral condylar hypoplasia using axial MRI images in patients with complete discoid meniscus. Knee Surg Sports Traumatol Arthrosc 24:909–914

    Article  PubMed  Google Scholar 

  32. Yamanaka N, Takahashi T, Ichikawa N, Yamamoto H (2003) Posterior-anterior weight-bearing radiograph in 15 knee flexion in medial osteoarthritis. Skelet Radiol 32:28–34

    Article  Google Scholar 

  33. Yasuda T, Ota S, Fujita S, Onishi E, Iwaki K, Yamamoto H (2017) Association between medial meniscus extrusion and spontaneous osteonecrosis of the knee. Int J Rheum Dis. https://doi.org/10.1111/1756-185X.13074

    Article  PubMed  Google Scholar 

  34. Yilgor C, Atay OA, Ergen B, Doral MN (2014) Comparison of magnetic resonance imaging findings with arthroscopic findings in discoid meniscus. Knee Surg Sports Traumatol Arthrosc 22:268–273

    Article  PubMed  Google Scholar 

  35. Young R (1889) The external semilunar cartilage as a complete disc. In: Cleland J, Mackay J, Young R (eds) Memoirs and memoranda in anatomy. Williams and Norgate, London, p 179

    Google Scholar 

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Acknowledgements

The authors declare that this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding

The authors declare that no funds were received in support of this study and that they have no competing interests. No benefits in any form have been or will be received from any commercial entity that is related directly or indirectly to this work.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China

    Zhong Zhang, Xiao-Ke Shang, Bei-Ni Mao, Jian Li & Gang Chen

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  1. Zhong Zhang
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  2. Xiao-Ke Shang
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Correspondence to Gang Chen.

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The authors have no conflicts of interest concerning this article.

Ethical approval

Protocols were approved by the Institutional Review Board (IRB) of West China Hospital, Sichuan University (ID 20160226).

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Informed consent was obtained in all cases.

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Zhang, Z., Shang, XK., Mao, BN. et al. Torn discoid lateral meniscus is associated with increased medial meniscal extrusion and worse articular cartilage status in older patients. Knee Surg Sports Traumatol Arthrosc 27, 2624–2631 (2019). https://doi.org/10.1007/s00167-018-5287-6

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  • DOI: https://doi.org/10.1007/s00167-018-5287-6

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