Joshi Deepak, Jain Vineet, Goyal Ankit, Bahl Vibhu, Chaudhary Deepak
Orthopedics. 2013 Nov;36(11):e1461-3. doi: 10.3928/01477447-20131021-34.
Discoid meniscus is an abnormality of the knee in which the meniscus is discoid rather than semilunar in shape. Medial discoid menisci are rare, and no specific associated symptoms suggest this condition. Several medial meniscus anomalies, including discoid variants, have been reported in the literature. This article describes a rare case of medial discoid meniscus completely coalesced with the anterior cruciate ligament (ACL). A 22-year-old man presented with intermittent right knee pain of 6 months' duration. Physical examination revealed mild wasting of the quadriceps with medial joint line tenderness but no effusion. Radiographically, hypoplasia of the lateral tibial spine, increased medial joint space, and increased concavity of the medial tibial condyle were noted in both knees. Arthroscopic examination revealed a complete discoid medial meniscus that was contiguous with the ACL. On probing, a horizontal tear in the medial meniscus was noted. A meniscectomy was performed, and deep longitudinal furrows with exposed subchondral bone were noted underlying the posteromedial tibial condyle. At the patient's 6-month follow-up visit, he had no knee symptoms and had returned to his daily activities, which included jogging. Discoid medial meniscus is a rare anomaly, and this case represents only the second reported in the literature of discoid medial meniscus completely coalesced with ACL. This case supports the theory that the ACL and menisci can be differentiated from 1 mesenchyme.
盘状半月板是膝关节的一种异常情况,其中半月板呈盘状而非半月形。内侧盘状半月板较为罕见,且没有特定的相关症状提示这种情况。文献中已报道了几种内侧半月板异常,包括盘状变异。本文描述了一例罕见的内侧盘状半月板与前交叉韧带(ACL)完全融合的病例。一名22岁男性出现持续6个月的间歇性右膝疼痛。体格检查发现股四头肌轻度萎缩,内侧关节线压痛,但无积液。影像学检查显示,双膝均有外侧胫骨棘发育不全、内侧关节间隙增宽以及内侧胫骨髁凹陷加深。关节镜检查发现一个完整的盘状内侧半月板与ACL相邻。探查时,发现内侧半月板有水平撕裂。进行了半月板切除术,在内侧胫骨髁后内侧下方发现了伴有裸露软骨下骨的深纵向沟。在患者6个月的随访中,他没有膝关节症状,已恢复日常活动,包括慢跑。内侧盘状半月板是一种罕见的异常情况,该病例是文献中报道的第二例内侧盘状半月板与ACL完全融合的病例。该病例支持ACL和半月板可从1种间充质分化而来的理论。