Discoid meniscus:Treatment considerations and updates

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.

Lessons Learned from a Case with Valgus Deformity of the Knee Following Partial Removal of Lateral Discoid Meniscus

Few studies have focused on the possible change in the axial alignment of the lower limb after lateral meniscectomy. Here, we present a patient with valgus deformity of the knee following the partial removal of lateral discoid meniscus. With the distal femur osteotomy and fixation, this complication was treated successfully. This case suggested that we should pay more attention to the axial alignment of the lower limb in patients with torn discoid lateral meniscus before meniscectomy, as a severe valgus inclination may develop in some of these patients.

Discoid medial meniscus of both knees:A case report

BACKGROUND Discoid meniscus is a congenital anomaly that typically affects the lateral meniscus.The appearance of the discoid medial meniscus in both knees is extremely rare,with an incidence of only 0.012%.CASE SUMMARY Our patient was a 30-year-old female.Under no obvious predisposing causes,she began to experience pain in both knees,which worsened while walking and squatting.The pain was aggravated after exercise,and joint flexion and extension activities were accompanied by knee snapping.Apley’s test was positive on physical examination,and there was a pressing pain in the medial articular space.Plain radiographs of both knees revealed no obvious abnormalities in the bilateral knee joint space.Partial meniscectomy as well as menisci reformation were performed on both knees under arthroscopy.Under the guidance of rehabilitation,the patient’s range of motion in both knees returned to normal without pain and knee snapping.CONCLUSION This study showed that the clinical manifestations of the discoid medial meniscus injury are identical to those of the conventional medial meniscus injury,and arthroscopic surgery is effective.

ARTHROSCOPIC TREATMENT FOR DISCOID LATERAL MENISCUS INJURY OF THE KNEE IN CHILDREN

Objective To study the arthroscopic treatment results for discoid lateral meniscus injury of the knee in children. Methods 74 children patients, including 98 knees underwent arthroscopic treatment due to discoid lateral meniscus injury were followed up. By Watanabe classification, incomplete discoid menis-cus was seen in 34 knees, complete in 42 and Wrisberg type in 22. The methods of treatment were partial, subtotal or total meniscectomy. The follow-up time ranged from 3 to 24 months, averaged 8 months. The re-sults were analyzed according to Lysholm knee evaluation method. Results By Lysholm evaluation the re-sults were excellent in 68 knees (69. 4%) and good in 30 (30. 6%). Conclusion Arthroscopic treatment is a reliable way for discoid lateral meniscus injury in children.

Torn discoid lateral meniscus treated with arthroscopic meniscectomy:observations in 62 knees

Background Discoid lateral meniscus of the knee is common in Chinese population. There has been considerable debate about the best treatment for discoid lateral meniscus tears. The purpose of this study was to observe the effect of arthroscopic meniscectomy for the treatment of discoid lateral meniscus tears. Methods Between July 1999 and December 2004, arthroscopic meniscectomy was performed on 62 menisci of 57 patients with discoid lateral meniscus tears （52 unilateral, 5 bilateral）. 41 menisci were ＂complete discoid meniscus＂, 21 =incomplete＂. According to the extent of the meniscus tears, partial meniscectomy was performed on 52 knees, total meniscectomy on 7 knees, and partial meniscectomy combined with meniscus suture on 3 knees through an arthroscope After the operations, early rehabilitation training programs, including straight-leg-raising and range-of-motion exercises, were carried out. 51 patients were followed up for 1 year 2 months to 6 years 5 months （mean, 3 years 3 months）, 6 patients were lost. Lysholm-Ⅱ scoring system was used to assess the function of the knee joints before the operation and during the follow-up. Results The operations on all the 62 knees were successful without complications. The patients could walk normally after completing the 2-week postoperation rehabilitation program. After 3-4 weeks they could lead a normal life and participate in a moderate amount of sports or other physical activities. The mean Lysholm-Ⅱ score was 89 （60--100） during the follow-up, which was significantly higher than that before the operation （50, range 34-74; P〈0.01）. 88% of the patients achieved excellent or good clinical results. Conclusions Arthroscopic meniscectomy is an alternative for treatment of discoid lateral meniscus tears with minimal traumatic effects. It can achieve early mobilization and a low complication rate, as well as the preservation of the meniscus structure and functions to the largest extent. In combination with proper rehabilitation training, the operation can lead to good or excellent results.