Skip to main content

Advertisement

SpringerLink
Log in

Effect of arthroscopic resection for discoid lateral meniscus on the axial alignment of the lower limb

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to investigate the changes in the lower limb axial alignment and knee joint function after arthroscopic resection of discoid lateral menisci.

Methods

Pre-operative and post-operative full-length weight-bearing radiographs of the lower limb were obtained from 60 patients with discoid lateral menisci from August 2015 to August 2016. Twenty-four patients were treated with meniscectomy and 36 cases were treated with meniscoplasty. The axial alignment of the lower limb was measured, and changes in the lower limb axial alignment before and after surgery were analyzed. The effects of differing degrees of meniscal resection on the lower limb axial alignment were compared and analyzed. Knee joint function on the affected side was scored using the Lysholm knee scoring, Tegner activity, and International Knee Documentation Committee (IKDC) subjective scales before surgery and one, six and 12 months after surgery.

Results

There were apparent changes in the lower limb axial alignment after surgery (p < 0.01). The changes were more conspicuous after a total meniscectomy than a meniscoplasty but were insignificant (p > 0.05). Intragroup comparisons of the Lysholm knee, IKDC, and Tegner scores before and after surgery revealed significant differences (p < 001). However, the differences were not significant between the two surgical approaches (p > 0.05).

Conclusion

For those with considerable genu varum or genu valgum after surgery, individualized therapy should be developed to correct the lower limb axial alignment and to prevent articular cartilage degeneration. Arthroscopic resection of a discoid lateral meniscus greatly improves knee joint function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Young RB (1889) The external semilunar cartilage as a complete discoid meniscus and memoranda in anatomy. Williams and Nortage, London

    Google Scholar 

  2. Albertsson M, Gillquist J (1988) Discoid lateral menisci: a report of 29 cases. Arthroscopy 4(3):211–214

    Article  PubMed  CAS  Google Scholar 

  3. Ikeuchi H (1982) Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results. Clin Orthop Relat Res 167:19–28

    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(3):475–478. https://doi.org/10.1177/0363546506294678

    Article  PubMed  Google Scholar 

  5. Javois C, Tardieu C, Lebel B, Seil R, Hulet C, Société, française,d’arthroscopie (2009) Comparative anatomy of the knee joint: effects on the lateral meniscus. Orthop Traumatol Surg Res 95(8):49–59. https://doi.org/10.1016/j.otsr.2009.09.008

    Article  Google Scholar 

  6. Allen PR, Denham RA, Swan AV (1984) Late degenerative changes after meniscectomy: factors affecting the knee after operation. J Bone Joint Surg Br 66(5):666–671

    Article  PubMed  CAS  Google Scholar 

  7. Proctor CS, Schmidt MB, Whipple RR, Kelly MA, Mow VC (1989) Material properties of the normal medial bovine meniscus. J Orthop Res 7(6):771–782

    Article  PubMed  CAS  Google Scholar 

  8. Cameron HU, Macnab I (1972) The structure of the meniscus of the human knee joint. Clin Orthop Relat Res 89:215–219

    Article  PubMed  CAS  Google Scholar 

  9. Newman AP, Anderson DR, Daniels AU, Dales MC (1989) Mechanics of the healed meniscus in a canine model. Am J Sports Med 17(2):164–175

    Article  PubMed  CAS  Google Scholar 

  10. Zhu W, Chern KY, Mow VC (1994) Anisotropic viscoelastic shear properties of bovine meniscus. Clin Orthop Relat Res 306:34–45

    Google Scholar 

  11. Tissakht M, Ahmed AM, Chan KC (1996) Calculated stress-shielding in the distal femur after total knee replacement corresponds to the reported location of bone loss. J Orthop Res 14:778–785. https://doi.org/10.1002/jor.1100140515

    Article  PubMed  CAS  Google Scholar 

  12. Noyes FR, Barber-Westin SD (2010) Repair of complex and avascular meniscal tears and meniscal transplantation. J Bone Joint Surg Am 92(4):1012–1029

    PubMed  Google Scholar 

  13. Fukubayashi T, Kurosawa H (1980) The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. Acta Orthop Scand 51(6):871–879

    Article  PubMed  CAS  Google Scholar 

  14. Ahmed AM, Burke DL (1983) In-vitro measurement of static pressure distribution in synovial joints—part I: Tibial surface of the knee. J Biomech Eng 105(3):216–225

    Article  PubMed  CAS  Google Scholar 

  15. Walker PS, Erkman MJ (1975) The role of the menisci in force transmission across the knee. Clin Orthop Relat Res 109:184–192

    Article  Google Scholar 

  16. Wilson W, van Rietbergen B, van Donkelaaar CC, Huiskes R (2003) Pathways of load-induced cartilage damage causing cartilage degeneration in the knee after meniscecctomy. J Biomech 36(6):845–851

    Article  PubMed  CAS  Google Scholar 

  17. Paletta GA Jr, Manning T, Snell E, Parker R, Bergfeld J (1997) The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee. A biomechanical study. Am J Sports Med 25(5):692–698. https://doi.org/10.1177/036354659702500519

    Article  PubMed  Google Scholar 

  18. Kurosawa H, Fukubayashi T, Nakajima H (1980) Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci. Clin Orthop Relat Res 149:283–290

    Google Scholar 

  19. Tanamas S, Hanna FS, Cicuttini FM, Wluka AE, Berry P, Urquhart DM (2009) Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum 61(4):459–467. https://doi.org/10.1002/art.24336

    Article  PubMed  Google Scholar 

  20. Sharma L, Song J, Dunlop D, Felson D, Lewis CE, Segal N, Torner J, Cooke TD, Hietpas J, Lynch J, Nevitt M (2010) Varus and Valgus alignment and incident and progressive knee osteoarthritis. Ann Rheum Dis 69(11):1940–1945. https://doi.org/10.1136/ard.2010.129742

    Article  PubMed  PubMed Central  Google Scholar 

  21. Prakash J, Song EK, Lim HA, Shin YJ, Jin C, Seon JK (2017) High tibial osteotomy accelerates lateral compartment osteoarthritis in discoid meniscus patients. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4422-0

  22. Ramme AJ, Strauss EJ, Jazrawi L, Gold HT (2016) Cost effectiveness of meniscal allograft for torn discoid lateral meniscus in young women. Phys Sportsmed 44(3):278–282

    Article  PubMed  Google Scholar 

  23. 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(6):932–936

    Article  CAS  Google Scholar 

  24. Yoo WJ, Jang WY, Park MS, Chung CY, Cheon JE, Cho TJ, Choi IH (2015) Arthroscopic treatment for symptomatic discoid meniscus in children: midterm outcomes and prognostic factors. Arthroscopy 31(12):2327–2334. https://doi.org/10.1016/j.arthro.2015.06.032

    Article  PubMed  Google Scholar 

  25. Okazaki K, Miura H, Matsuda S, Hashizume M, Iwamoto Y (2006) Arthroscopic resection of the discoid lateral meniscus: long-term follow-up for 16 years. Arthroscopy 22(9):967–971. https://doi.org/10.1016/j.arthro.2006.04.107

    Article  PubMed  Google Scholar 

  26. Kim SJ, Chun YM, Jeong JH, Ryu SW, Oh KS, Lubis AM (2007) Effects of arthroscopic meniscectomy on the long-term prognosis for the discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 15(11):1315–1320. https://doi.org/10.1007/s00167-007-0391-z

    Article  PubMed  Google Scholar 

  27. Ahn JH, Kim KI, Wang JH, Jeon JW, Cho YC, Lee SH (2015) Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthroscopy 31(5):867–873. https://doi.org/10.1016/j.arthro.2014.12.012

    Article  PubMed  Google Scholar 

  28. Lee DH, Kim TH, Kim JM, Bin SI (2009) Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Arthroscopy 25(5):496–503. https://doi.org/10.1016/j.arthro.2008.10.025

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopedic Department, Anhui Provincial Hospital, Anhui Medical University, Hefei, 230001, China

    Puyan Zhang, Qichun Zhao, Xifu Shang & Yingming Wang

Authors
  1. Puyan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qichun Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xifu Shang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yingming Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qichun Zhao.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was obtained from the hospital Ethics Committee. Authors had to obtain patient consent before enrolling participants in this study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, P., Zhao, Q., Shang, X. et al. Effect of arthroscopic resection for discoid lateral meniscus on the axial alignment of the lower limb. International Orthopaedics (SICOT) 42, 1897–1903 (2018). https://doi.org/10.1007/s00264-018-3944-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-018-3944-5

Keywords

Search

Navigation