Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
Arthroscopy. 2010 Oct;26(10):1348-56. doi: 10.1016/j.arthro.2010.02.008. Epub 2010 Aug 21.
The aim of this study was to analyze, by use of magnetic resonance imaging (MRI), the contralateral discoid lateral meniscus (DLM) status of 33 patients who underwent an operation for a symptomatic DLM.
This diagnostic study included 33 consecutive patients who underwent arthroscopic surgery for a unilaterally symptomatic DLM. All patients' contralateral knees were checked with simple radiographs and MRI scans. Knees were also evaluated through physical examinations and a clinical scoring system. On the basis of the MRI findings, DLM was categorized into 3 types: normal type, incomplete discoid type, and complete discoid type. The tear patterns of the lateral menisci as imaged by radiographs and the associated chondral lesions imaged by MRI were analyzed by consensus in the bilateral knees.
All but 1 of the contralateral, asymptomatic knees (97%) were diagnosed by MRI to have complete or incomplete DLM. DLMs with tears were found in the contralateral knees in 11 cases (33%), and chondral lesions were found in 4 (12%) of the complete discoid type cases. On radiography, 23 (70%) of the 33 contralateral knees showed characteristic findings of DLM. We found that 29 pairs of knees (88%) had the same lateral meniscus shape on MRI. A κ analysis showed significant and good agreement between the radiographic findings, the tear pattern of the lateral menisci, and the associated chondral lesions on MRI scans in bilateral knees.
DLM commonly occurs bilaterally in patients with symptomatic, unilateral surgical DLM, although this finding was applicable only to young, Asian male patients. Characteristic radiographic findings and the MRI findings of symptomatic DLM patients were significantly correlated between both knees.
Level I, testing of previously developed diagnostic criteria in a series of consecutive patients with universally applied reference gold standard.
本研究旨在通过磁共振成像（MRI）分析 33 例接受手术治疗的症状性外侧盘状半月板（DLM）患者的对侧盘状外侧半月板（DLM）状况。
本研究为诊断性研究，纳入 33 例因单侧症状性 DLM 行关节镜手术的连续患者。所有患者的对侧膝关节均接受了简单的 X 线和 MRI 检查。膝关节还通过体格检查和临床评分系统进行了评估。根据 MRI 结果，将 DLM 分为 3 型：正常型、不完全盘状型和完全盘状型。通过 X 线和 MRI 分析外侧半月板的撕裂模式和相关的软骨损伤。
除 1 例（97%）外，所有对侧无症状膝关节（97%）均通过 MRI 诊断为完全或不完全 DLM。在 11 例（33%）对侧膝关节中发现有 DLM 伴撕裂，在 4 例（12%）完全盘状型中发现有软骨损伤。在 X 线上，33 例对侧膝关节中有 23 例（70%）表现出 DLM 的特征性表现。我们发现 29 对膝关节（88%）的外侧半月板在 MRI 上形状相同。κ 分析显示，双侧膝关节的 X 线表现、外侧半月板撕裂模式和 MRI 扫描上的相关软骨损伤之间具有显著的良好一致性。
尽管这一发现仅适用于年轻的亚洲男性患者，但在有症状的单侧手术 DLM 患者中，双侧 DLM 很常见。双侧膝关节的特征性 X 线表现和症状性 DLM 患者的 MRI 表现之间存在显著相关性。
I 级，在一系列连续的患者中测试以前开发的诊断标准，这些患者均应用了普遍适用的参考金标准。
