Wang Hong-De, Gao Shi-Jun
aDepartment of Orthopedics, Third Hospital of Hebei Medical University bOrthopaedic Biomechanics Laboratory of Hebei Province, Shijiazhuang, Hebei, People's Republic of China.
Medicine (Baltimore). 2017 Nov;96(46):e8637. doi: 10.1097/MD.0000000000008637.
Bilateral discoid medial menisci is an extremely rare abnormality of the knee joint. The presence of a discoid medial meniscus has been associated with magnetic resonance imaging (MRI) and radiographic changes in the tibial region, such as cupping of the medial tibial plateau and tibial physis collapse. While discoid medial meniscal tears with hypoplasia of the femoral medial condyles have not been previously reported. Herein, we report a case of bilateral discoid medial menisci associated with meniscal tears and femoral bone changes.
A 28-year-old man presented with left knee pain and restricted range of motion; the right knee was asymptomatic.
Based on radiographic and MRI findings, he was diagnosed with bilateral discoid medial meniscal tears.
Partial meniscectomy and reshaping were performed for the torn discoid medial meniscus of the left knee only.
MRI revealed short, flattened femoral medial condyles in the coronal and sagittal planes, and hypoplasia of the femoral medial condyles in the axial plane; these findings were confirmed arthroscopically in the left knee. The patient had a satisfactory results at the 12-month follow-up.
This case indicates a potential link between discoid medial menisci and hypoplasia of the femoral medial condyle. We recommend preservation of the discoid medial meniscus in asymptomatic patients, while arthroscopic partial meniscectomy and reshaping is recommended in symptomatic patients.
双侧盘状内侧半月板是膝关节极为罕见的异常情况。盘状内侧半月板的存在与磁共振成像(MRI)及胫骨区域的影像学改变有关,如胫骨内侧平台凹陷和胫骨骨骺塌陷。然而,此前尚未报道过伴有股骨内侧髁发育不全的盘状内侧半月板撕裂。在此,我们报告一例伴有半月板撕裂和股骨骨质改变的双侧盘状内侧半月板病例。
一名28岁男性因左膝疼痛和活动范围受限就诊;右膝无症状。
根据影像学和MRI检查结果,他被诊断为双侧盘状内侧半月板撕裂。
仅对左膝撕裂的盘状内侧半月板进行了部分半月板切除术和重塑手术。
MRI显示在冠状面和矢状面股骨内侧髁短而扁平,在轴位面上股骨内侧髁发育不全;这些结果在左膝关节镜检查中得到证实。患者在12个月随访时效果满意。
该病例表明盘状内侧半月板与股骨内侧髁发育不全之间可能存在联系。我们建议对无症状患者保留盘状内侧半月板,而对有症状患者建议进行关节镜下部分半月板切除术和重塑手术。