A discoid meniscus is a morphological abnormality wherein the meniscus loses its normal‘C’shape.Although most patients are asymptomatic,patients might still present with symptoms such as locking,pain,swelling,or giv...A discoid meniscus is a morphological abnormality wherein the meniscus loses its normal‘C’shape.Although most patients are asymptomatic,patients might still present with symptoms such as locking,pain,swelling,or giving way.Magnetic resonance imaging is usually needed for confirmation of diagnosis.Based on a constellation of factors,including clinical and radiological,different approaches are chosen for the management of discoid meniscus.The purpose of this review is to outline the treatment of discoid meniscus,starting from conservative approach,to the different surgical options for this condition.The PubMed and Google Scholar databases were used for this review.Studies discussing the treatment of discoid meniscus from 2018 to 2023 were searched.Initially there were 369 studies retrieved,and after removal of studies using the exclusion criteria,26 studies were included in this review.Factors such as stability,presence of tear,and morphology can help with surgical planning.Many approaches have been used to treat discoid meniscus,where the choice is tailored for each patient individually.Postoperatively,factors that may positively impact patient outcomes include male sex,body mass index<18.5,age at symptom onset<25 years,and duration of symptoms<24 months.The conventional approach is partial meniscectomy with or without repair;however,recently,there has been an increased emphasis on discoid-preserving techniques such as meniscoplasty,meniscopexy,and meniscal allograft transplantation.展开更多
Background：Many studies suggest that the gamma irradiation decreases allograft strength in a dose-dependent manner.However,no study has demonstrated that this decrease in strength translates into higher failure rate ...Background：Many studies suggest that the gamma irradiation decreases allograft strength in a dose-dependent manner.However,no study has demonstrated that this decrease in strength translates into higher failure rate in meniscal allograft transplantation （MAT）.The aim of this study was to investigate the effects of gamma irradiation on macroscopic and histological alterations of transplanted meniscal tissue and joint cartilage after MAT.Methods：Medial total meniscectomies were performed on the right knees of 60 New Zealand white rabbits.All meniscal allografts were divided into three groups （20 in each group） and then sterilized with 0 Mrad,1.5 Mrad,or 2.5 Mrad of gamma irradiation.For each group,5 menisci were randomly chosen for scanning electron microscopic （SEM） analysis and the remaining 15 were prepared for MAT surgeries.Forty-five right knees received MAT surgeries （0 Mrad group,1.5 Mrad group,2.5 Mrad group,15 in each group）,whereas the remaining 15 only received medial meniscectomy （Meni group）.The left knees of the Meni group were chosen as the Sham group （n =15）.All the rabbits were sacrificed at week 24 postoperatively.Cartilage of the medial compartment of each group was evaluated macroscopically using the International Cartilage Repair Society （ICRS） score and then histologically using the Mankin score based on the Masson Trichrome staining.Results：The SEM analysis confirmed that the meniscal collagen fibers would be significantly damaged as the dose of gamma irradiation increased.At week 24,the overall scores of macroscopic evaluations of the transplanted meniscal tissue showed no significant differences among the three groups receiving MAT surgeries,except for 2 in the 2.5 Mrad group presented partial radial tears at midbody.The ICRS scores and the Mankin scores showed the lowest in the Sham group and the highest in the Meni group （P 〈 0.05）.For the three groups receiving MAT surgeries,the 2.5 Mrad group showed significant higher ICRS scores and Mankin scores than both the 0 Mrad group and the 1.5 Mrad group （P 〈 0.05）.Whereas the 1.5 Mrad group presented similar results to the 0 Mrad group concerning both the ICRS scores and the Mankin scores.Conclusions：The current in vivo animal study proved that although the meniscal collagen fibers were damaged after gamma irradiation,the failure rate of MAT surgeries might not significantly increase if the irradiation dose was 〈1.5 Mrad for New Zealand white rabbits.展开更多
文摘A discoid meniscus is a morphological abnormality wherein the meniscus loses its normal‘C’shape.Although most patients are asymptomatic,patients might still present with symptoms such as locking,pain,swelling,or giving way.Magnetic resonance imaging is usually needed for confirmation of diagnosis.Based on a constellation of factors,including clinical and radiological,different approaches are chosen for the management of discoid meniscus.The purpose of this review is to outline the treatment of discoid meniscus,starting from conservative approach,to the different surgical options for this condition.The PubMed and Google Scholar databases were used for this review.Studies discussing the treatment of discoid meniscus from 2018 to 2023 were searched.Initially there were 369 studies retrieved,and after removal of studies using the exclusion criteria,26 studies were included in this review.Factors such as stability,presence of tear,and morphology can help with surgical planning.Many approaches have been used to treat discoid meniscus,where the choice is tailored for each patient individually.Postoperatively,factors that may positively impact patient outcomes include male sex,body mass index<18.5,age at symptom onset<25 years,and duration of symptoms<24 months.The conventional approach is partial meniscectomy with or without repair;however,recently,there has been an increased emphasis on discoid-preserving techniques such as meniscoplasty,meniscopexy,and meniscal allograft transplantation.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 81401814）. Conflict of Interest： None declared.
文摘Background：Many studies suggest that the gamma irradiation decreases allograft strength in a dose-dependent manner.However,no study has demonstrated that this decrease in strength translates into higher failure rate in meniscal allograft transplantation （MAT）.The aim of this study was to investigate the effects of gamma irradiation on macroscopic and histological alterations of transplanted meniscal tissue and joint cartilage after MAT.Methods：Medial total meniscectomies were performed on the right knees of 60 New Zealand white rabbits.All meniscal allografts were divided into three groups （20 in each group） and then sterilized with 0 Mrad,1.5 Mrad,or 2.5 Mrad of gamma irradiation.For each group,5 menisci were randomly chosen for scanning electron microscopic （SEM） analysis and the remaining 15 were prepared for MAT surgeries.Forty-five right knees received MAT surgeries （0 Mrad group,1.5 Mrad group,2.5 Mrad group,15 in each group）,whereas the remaining 15 only received medial meniscectomy （Meni group）.The left knees of the Meni group were chosen as the Sham group （n =15）.All the rabbits were sacrificed at week 24 postoperatively.Cartilage of the medial compartment of each group was evaluated macroscopically using the International Cartilage Repair Society （ICRS） score and then histologically using the Mankin score based on the Masson Trichrome staining.Results：The SEM analysis confirmed that the meniscal collagen fibers would be significantly damaged as the dose of gamma irradiation increased.At week 24,the overall scores of macroscopic evaluations of the transplanted meniscal tissue showed no significant differences among the three groups receiving MAT surgeries,except for 2 in the 2.5 Mrad group presented partial radial tears at midbody.The ICRS scores and the Mankin scores showed the lowest in the Sham group and the highest in the Meni group （P 〈 0.05）.For the three groups receiving MAT surgeries,the 2.5 Mrad group showed significant higher ICRS scores and Mankin scores than both the 0 Mrad group and the 1.5 Mrad group （P 〈 0.05）.Whereas the 1.5 Mrad group presented similar results to the 0 Mrad group concerning both the ICRS scores and the Mankin scores.Conclusions：The current in vivo animal study proved that although the meniscal collagen fibers were damaged after gamma irradiation,the failure rate of MAT surgeries might not significantly increase if the irradiation dose was 〈1.5 Mrad for New Zealand white rabbits.
