Torn Discoid Lateral Meniscus is Associated with Increased Medial Meniscal Extrusion and Worse Articular Cartilage Status in Older Patients

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2018 Dec 5

PMID 30511095

Citations 7

Authors

Zhong Zhang

Xiao-Ke Shang

Bei-Ni Mao

Jian Li

Gang Chen

Affiliations

Soon will be listed here.

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.

Citing Articles

Meniscectomy is associated with a higher rate of osteoarthritis compared to meniscal repair following acute tears: a meta-analysis.

Migliorini F, Schafer L, Bell A, Weber C, Vecchio G, Maffulli N Knee Surg Sports Traumatol Arthrosc. 2023; 31(12):5485-5495.

PMID: 37812251 PMC: 10719156. DOI: 10.1007/s00167-023-07600-y.

Older age and the presence of intrameniscal signs are risk factors for nonsurgical treatment failure of symptomatic intact discoid lateral meniscus.

Luo Z, Qian J, Lu X, Fan Y, Chang X, Jiang B Knee Surg Sports Traumatol Arthrosc. 2023; 31(11):5154-5161.

PMID: 37755474 DOI: 10.1007/s00167-023-07586-7.

Chinese Experts Consensus and Practice Guideline on Discoid Lateral Meniscus.

Yang S, Zhang S, Li R, Yang C, Zheng J, Wang C Orthop Surg. 2023; 15(4):915-929.

PMID: 36878896 PMC: 10102324. DOI: 10.1111/os.13687.

Surgical Repair of Symptomatic Wrisberg Variant Discoid Lateral Mensicus with Pull-Out Repair and Capsulodesis.

Ozeki N, Koga H, Nakamura T, Nakagawa Y, Ohara T, Kohno Y Arthrosc Tech. 2022; 11(1):e61-e68.

PMID: 35127430 PMC: 8807856. DOI: 10.1016/j.eats.2021.09.003.

Factors influencing postoperative outcomes in patients with symptomatic discoid lateral meniscus.

Yang S, Ding Z, Li J, Xue Y, Chen G BMC Musculoskelet Disord. 2020; 21(1):551.

PMID: 32799843 PMC: 7429813. DOI: 10.1186/s12891-020-03573-y.

References

Adams J, McAlindon T, Dimasi M, Carey J, Eustace S . Contribution of meniscal extrusion and cartilage loss to joint space narrowing in osteoarthritis. Clin Radiol. 1999; 54(8):502-6. DOI: 10.1016/s0009-9260(99)90846-2. View

Nawata K, Teshima R, Ohno M, Takita T, Otuki K . Discoid lateral menisci in older patients. A radiographic study of 21 cases. Int Orthop. 1999; 23(4):232-5. PMC: 3619736. DOI: 10.1007/s002640050358. View

Rao P, Rao S, Paul R . Clinical, radiologic, and arthroscopic assessment of discoid lateral meniscus. Arthroscopy. 2001; 17(3):275-277. DOI: 10.1053/jars.2001.19973. View

Levine M, Ensom M . Post hoc power analysis: an idea whose time has passed?. Pharmacotherapy. 2001; 21(4):405-9. DOI: 10.1592/phco.21.5.405.34503. View

Min B, Ha H, Khang S . Medial discoid meniscus completely coalesced with the anterior cruciate ligament. Arthroscopy. 2001; 17(7):E27. DOI: 10.1053/jars.2001.23589. View

Ahn J, Shim J, Hwang C, Oh W . Discoid lateral meniscus in children: clinical manifestations and morphology. J Pediatr Orthop. 2001; 21(6):812-6. View

Walker P, Erkman M . The role of the menisci in force transmission across the knee. Clin Orthop Relat Res. 1975; (109):184-92. DOI: 10.1097/00003086-197506000-00027. View

Kelly B, Green D . Discoid lateral meniscus in children. Curr Opin Pediatr. 2002; 14(1):54-61. DOI: 10.1097/00008480-200202000-00010. View

Yamanaka N, Takahashi T, Ichikawa N, Yamamoto H . Posterior-anterior weight-bearing radiograph in 15 degree knee flexion in medial osteoarthritis. Skeletal Radiol. 2003; 32(1):28-34. DOI: 10.1007/s00256-002-0574-0. View

10.

Brittberg M, Winalski C . Evaluation of cartilage injuries and repair. J Bone Joint Surg Am. 2003; 85-A Suppl 2:58-69. DOI: 10.2106/00004623-200300002-00008. View

11.

Englund M, Roos E, Lohmander L . Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis: a sixteen-year followup of meniscectomy with matched controls. Arthritis Rheum. 2003; 48(8):2178-87. DOI: 10.1002/art.11088. View

12.

Ogut T, Kesmezacar H, Akgun I, Cansu E . Arthroscopic meniscectomy for discoid lateral meniscus in children and adolescents: 4.5 year follow-up. J Pediatr Orthop B. 2003; 12(6):390-7. DOI: 10.1097/01202412-200311000-00007. View

13.

Christoforakis J, Pradhan R, Sanchez-Ballester J, Hunt N, Strachan R . Is there an association between articular cartilage changes and degenerative meniscus tears?. Arthroscopy. 2005; 21(11):1366-9. DOI: 10.1016/j.arthro.2005.08.031. View

14.

Gicquel P, Sorriaux G, Clavert J, Bonnomet F . [Discoid menisci in children: clinical patterns and treatment in eighteen knees]. Rev Chir Orthop Reparatrice Appar Mot. 2005; 91(5):457-64. DOI: 10.1016/s0035-1040(05)84363-6. View

15.

Atay O, Pekmezci M, Doral M, Sargon M, Ayvaz M, Johnson D . Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med. 2007; 35(3):475-8. DOI: 10.1177/0363546506294678. View

16.

Lee D, Kim T, Kim J, Bin S . Results of subtotal/total or partial meniscectomy for discoid lateral meniscus in children. Arthroscopy. 2009; 25(5):496-503. DOI: 10.1016/j.arthro.2008.10.025. View

17.

Ding J, Zhao J, He Y, Huangfu X, Zeng B . Risk factors for articular cartilage lesions in symptomatic discoid lateral meniscus. Arthroscopy. 2009; 25(12):1423-6. DOI: 10.1016/j.arthro.2009.06.024. View

18.

Ahn J, Choi S, Lee Y, Yoo J, Chang M, Bae S . Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc. 2010; 19(2):158-64. DOI: 10.1007/s00167-010-1058-8. View

19.

Wong T, Wang C . Functional analysis on the treatment of torn discoid lateral meniscus. Knee. 2010; 18(6):369-72. DOI: 10.1016/j.knee.2010.07.002. View

20.

Chen L, Ao Y, Yu J, Miao Y, Leung K, Wang H . Clinical features and prognosis of discoid medial meniscus. Knee Surg Sports Traumatol Arthrosc. 2012; 21(2):398-402. DOI: 10.1007/s00167-012-1979-5. View