If the discoid meniscus is also torn, the surgeon may perform a saucerization and then trim away the torn portion. Gebhardt M, Rosenthal R. Bilateral lateral discoid meniscus in identical twins. Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA. In adolescents, clinical presentation varies and often includes symptoms typically found with meniscal tears. Orthopedic perspective on selected pediatric and adolescent knee conditions. In many cases discoid menisci can be monitored and observed. There are various treatments available, from simple observation to surgical stabilisation. Traditionally, the treatment for stable or unstable discoid meniscus is an open total meniscectomy. In patients with a painful discoid meniscus, simple treatments consisting of knee exercises and … Epub 2011 Mar 23. Partial tendon release for treatment of a symptomatic snapping biceps femoris tendon: a case report. 2010;26(10):1348–1356. The orthopaedic surgeon will make a few small incisions around the knee and use a small camera and surgical instruments to treat the meniscus. Magnetic resonance imaging classification of…, Magnetic resonance imaging classification of the discoid lateral meniscus (DLM) based on peripheral…, Treatment algorithm for patients with discoid lateral meniscus at our author’s institution, When performing partial meniscectomy for…, When performing partial meniscectomy for meniscal reshaping for patients with discoid lateral meniscus…, Arthroscopic view recorded during the treatment of the posterocentral shift type of complete…, Arthroscopic view recorded during treatment…, Arthroscopic view recorded during treatment of the anterocentral shift type of complete discoid…, National Library of Medicine Complete: The tibia is entirely covered by the meniscus. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. FOIA But recent research has proved that a partial meniscectomy of normal shaped menisci, was shown to increase the contact stresses in proportion to the amount of removed meniscus. Although DLM was traditionally classified into three categories, namely, complete, incomplete, and Wrisberg DLM, a recent MRI classification provides useful information for surgical planning because the MRI classification was based on the peripheral detachment in patients with DLM, as follows: no shift, anterocentral shift, posterocentral shift, and central shift. Epub 2017 Aug 17. (1)Department of Orthopedic Surgery, New York University-Hospital for Joint Diseases, New York, New York, USA. There are various treatments available, from simple observation to surgical stabilisation. When it is causing pain, popping, or other problems a discoid meniscus is usually treated with surgery. Grimm NL, Pace JL, Levy BJ, Arthur D, Portman M, Solomito MJ, Weiss JM. In many cases, the most effective treatment is to remove the part of the discoid meniscus … Prevention and treatment information (HHS). Although early recommendations for treatment of symptomatic discoid meniscus consisted primarily of total or subtotal meniscectomy, our understanding of the role of the meniscus in load-sharing and stability of the knee has led to expanded indications for meniscal preservation and meniscocapsular repair. Resection of 15–34% of the meniscus increases tibiofemoral contact pressures by more than 350%. Meniscus Tears. Although the etiology of the discoid lateral meniscus (DLM) has been the subject of debate, the entity is now believed to result from abnormal development secondary to a deficiency in normal attachments. Would you like email updates of new search results? Treatment of a Discoid Meniscus If patients are found to have a discoid meniscus, but it is not causing symptoms, no treatment should be performed. meniscal tears The inner area (white zone) lacks a good blood supply and therefore does not heal well. Recent reports of meniscal repair for the unstable Wrisberg meniscus have been encouraging. While simple radiographs may provide indirect signs of a DLM, magnetic resonance imaging (MRI) is essential for diagnosis and treatment planning. Pediatr Radiol. doi: 10.1177/0363546509332502. Arch Orthop Trauma Surg. Arthroscopy. treatment of discoid lateral meniscal tears has shown poor long-term results with total meniscectomy.6,7 An evolution in the contemporary literature strongly sup-ports repair with meniscal preservation in an effort to restore long-term function.8 Recent literature also sup- Previous studies have reported that partial meniscectomy with or without meniscal repair is effective and shows superior clinical and radiological outcomes to those of total or subtotal meniscectomy during the short- to long-term follow-up. Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up. Tears at the outer edge (red zone) tend to heal well because there is a good blood supply. 77 - … Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. 2012 Jan-Feb;32(1):5-8. doi: 10.1097/BPO.0b013e31823d3500. Discoid lateral meniscus: importance, diagnosis, and treatment Jun-Ho Kim1, Jin Hwan Ahn2, Joo-Hwan Kim3 and Joon Ho Wang3,4* Abstract Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. Complete and incomplete discoid meniscus with no tears are typically treated with saucerization, a procedure in which the meniscus is cut and re-shaped into a crescent. Discoid lateral meniscus of the knee joint; nature, mechanism, and operative treatment J Bone Joint Surg Am , 39–A ( 1957 ) , pp. Consideration for meniscal transplant should be given prior to the development of significant articular cartilage lesions. Epub 2015 Aug 6. Sometimes repairs (suturing/stitching) of meniscus is necessary to correct the meniscus, and this can only be assessed during surgery. Previous studies have reported that partial meniscectomy with or without meniscal repair is effective and shows superior clinical and radiological outcomes to those of total or subtotal meniscectomy during … https://www.verywellhealth.com/meniscus-tear-treatment-2549649 Incomplete: In this type, the meniscus is somewhat thicker and wider than normal. Ideally, the meniscus is preserved with conservative management. During arthroscopy, the surgeon inserts a small camera in the knee and uses these images to guide miniature surgical instruments. Symptomatic discoid lateral meniscus without tears has traditionally been treated with excision of part or the entire meniscus. In patients with a painful discoid meniscus, In addition to partial meniscectomy, meniscal repair of peripheral detachment is recommended for stabilization in patients with DLM to preserve the function of the meniscus. Early to midterm reports on saucerization and repair of discoid lateral meniscus in children are promising. Long-term follow-up after excision. Management of discoid lateral meniscus tears: observations in 34 knees. Arthroscopy. Orthop Clin North Am. If the discoid meniscus is also torn, the surgeon may perform a saucerization and then trim away the torn portion. “In cases where there is significant disability, surgical excision may be needed. Discoid meniscus is a possible cause of knee pain in children and adolescents, limiting daily and sports-related activities. Clipboard, Search History, and several other advanced features are temporarily unavailable. The problems associated with this condition, called discoid meniscus, can be significant. If they are causing problems, such as pain, locking or giving way, then they may require surgical management. Causes, symptoms, diagnosis and treatment by Prof. Portinaro, one of the most experienced orthopedic surgeons in the world for knee diseases and treatment. Demographics and Epidemiology of Discoid Menisci of the Knee: Analysis of a Large Regional Insurance Database. Lateral Meniscal Variants: Evaluation and Treatment. The discoid meniscus can be encountered incidentally during a treatment of another … 8600 Rockville Pike Although the historical treatment has been complete removal, more recent reports of saucerization of a discoid meniscus and reattachment present other options. The goal of surgery is to contour the discoid lateral meniscus to resemble a normal meniscus. Author information: (1)Department of Orthopedics, Changhai Hospital Affiliated to Second Military Medical University, Shanghai, China. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. A discoid meniscus is usually present if the meniscal body is seen on three or more standard sagittal slices - the opposite of the absent bow tie sign. Complete and incomplete discoid menisci with no tears are typically treated with saucerization, a procedure in which the meniscus is cut and re-shaped into a crescent. Treatments taken by people for discoid meniscus Let’s build this page together! Magnetic resonance imaging classification of the discoid lateral meniscus (DLM) based on peripheral detachment. asymptomatic discoid meniscus without tears ; Operative . 2015 Jul 28;16:172. doi: 10.1186/s12891-015-0626-y. These surgeries are done under anesthesia and patients are able to go home the same day. Unable to load your collection due to an error, Unable to load your delegates due to an error. 3. If the meniscus is torn, it may either require surgical repair or excision. When you share what it’s like to have discoid meniscus through your … Discoid lateral meniscus: current concepts. In children younger than 10 years, snapping knee syndrome is pathognomonic for an unstable DLM. Please enable it to take advantage of the complete set of features! The torn complete DLM was shifting to posterocentrally during knee flexion owing to a longitudinal tear of the anterior horn (, Arthroscopic view recorded during treatment of the anterocentral shift type of complete discoid lateral meniscus (DLM) on the right knee of a 12-year old girl. Treatment and prognosis Ideally, the meniscus is preserved with conservative management. Careers. If a discoid meniscus is not causing pain, popping, or other symptoms, then treatment may not be necessary. Would you like email updates of new search results? Yes, accurate identification of the discoid meniscus is essential to make sure your child needs to undergo general anesthesia and surgery. Discoid Meniscus affecting the medial meniscus (inside of the knee) is extremely rare – estimated at 0.1-0.3% of the population. 2004;20(5):536–542. A discoid meniscus is usually present if the meniscal body is seen on three or more standard sagittal slices - the opposite of the absent bow tie sign. A novel magnetic resonance imaging classification of discoid lateral meniscus based on peripheral attachment. If this is unsuccessful, then partial or total resection may be carried out. Discoid lateral meniscus in children. 2008;24(8):888–898. Bethesda, MD 20894, Copyright Orthop J Sports Med. 9 Several countries have … doi: 10.1016/j.arthro.2010.02.008. In some cases the entire meniscus needs to be excised due to UN repairable damage to the meniscus. Yamasaki S, Hashimoto Y, Takigami J, Terai S, Takahashi S, Nakamura H. Am J Sports Med. J Am Acad Orthop Surg. 2021 Feb 22. doi: 10.1007/s00402-021-03821-3. doi: 10.1016/j.arthro.2004.01.028. The authors declare that they have no competing interests. Thus, the first case of Turner’s syndrome with discoid meniscus and Blount’s disease is presented. Lateral Meniscal Variants: Evaluation and Treatment. eCollection 2020 Sep. Liu WX, Zhao JZ, Huangfu XQ, He YH, Yang XG. Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. Symptomatic bilateral discoid menisci in children: a comparison with unilaterally symptomatic patients. 2011 May;97(3):297-303. doi: 10.1016/j.otsr.2010.11.009. Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Long-term follow-up after excision. The discoid lateral-meniscus syndrome. Prevalence of bilateral Discoid Lateral Menisci (DLM) in patients operated for symptomatic DLM with a follow-up study on their asymptomatic contralateral knees: a Magnetic Resonance Imaging (MRI) assessment. Our preferred principle for DLM treatment is reduction, followed by reshaping with reference to the midbody of the medial meniscus and repair as firm as possible. Youm T (1), Chen AL. Arthroscopic treatment of discoid meniscus in children: clinical and MRI results. Treatment. See this image and copyright information in PMC. Privacy, Help 2018 Mar;138(3):369-376. doi: 10.1007/s00402-017-2853-1. Arthroscopic partial meniscectomy in young patients with symptomatic discoid lateral meniscus: an average 10-year follow-up study. Total or subtotal meniscectomy, which has been traditionally performed, leads to an increased risk of degenerative arthritis; thus, partial meniscectomy is currently considered the treatment of choice for DLM. Discoid lateral meniscus: prevalence of peripheral rim instability. Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations.
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