Seattle Children's, Seattle, Washington, USA.
Children's Hospital of Eastern Ontario, Ottowa, Ontario, Canada.
Am J Sports Med. 2023 Apr;51(5):1171-1176. doi: 10.1177/03635465231159671. Epub 2023 Mar 6.
The discoid medial meniscus is a rare congenital anomaly of the knee. The literature is limited to small case series.
PURPOSE/HYPOTHESIS: Our purpose is to report the clinical manifestations and operative treatments of discoid medial menisci in children from multiple centers in North America. We hypothesized that symptoms and signs, arthroscopic findings, surgical treatments, and outcomes are similar to those for symptomatic discoid lateral menisci.
Case series; Level of evidence, 4.
A retrospective review identified patients with a diagnosed discoid medial meniscus confirmed at surgery across 8 children's hospitals between January 2000 and June 2021. The literature on discoid lateral menisci was reviewed and summarized for comparison.
A total of 21 patients (9 female, 12 male) with 22 discoid medial menisci were identified. The mean ± SD age at the time of diagnosis was 12.8 ± 3.8 years. The most common symptoms and signs were locking and/or clunking, present in 12 of 22 knees (55%), similar to that reported in patients with discoid lateral menisci. Twelve discoid medial menisci were complete (55%); 8, incomplete (36%); and 2, indeterminate (9%). Tears were present in 13 knees, most commonly horizontal cleavage (54%). Five discoid medial menisci were unstable (23%): 3 for posterior tears and 2 for rim insufficiency. All 22 knees underwent arthroscopic saucerization, and of the 13 torn menisci, 7 (54%) were repaired. The median follow-up was 24 months (range, 2-82 months). Four knees underwent reoperation. All knees that required reoperation had undergone repair for a posteriorly located tear. There was a significant association between operative repair and need for reoperation ( = .0048). High rates of peripheral instability were also noted in case series of patients with discoid lateral menisci.
Patient presentations and treatments for those with discoid medial menisci were similar to those reported for patients with discoid lateral menisci. Knees with discoid medial menisci also demonstrated instability attributed to peripheral insufficiency and posterior tears. Tears were present in over half of knees with discoid medial menisci, and reoperation was more common in knees that underwent repair of tears than those without repair.
盘状内侧半月板是一种罕见的膝关节先天性异常。文献仅限于小病例系列。
目的/假设：我们的目的是报告北美多个中心儿童盘状内侧半月板的临床表现和手术治疗。我们假设症状和体征、关节镜检查结果、手术治疗和结果与症状性外侧盘状半月板相似。
病例系列；证据水平，4 级。
回顾性分析 2000 年 1 月至 2021 年 6 月期间，8 家儿童医院通过手术确诊的 21 例（9 名女性，12 名男性）22 例盘状内侧半月板患者。诊断时的平均年龄±标准差为 12.8±3.8 岁。最常见的症状和体征是锁定和/或弹响，22 个膝关节中有 12 个（55%）存在，与外侧盘状半月板患者相似。12 个盘状内侧半月板完全（55%）；8 个不完全（36%）；2 个不确定（9%）。13 个膝关节有撕裂，最常见的是水平分裂（54%）。5 个盘状内侧半月板不稳定（23%）：3 个有后撕裂，2 个有边缘不足。所有 22 个膝关节均行关节镜下盘状半月板切除术，在 13 个撕裂的半月板中，7 个（54%）行修补术。中位数随访时间为 24 个月（范围 2-82 个月）。4 个膝关节行再次手术。所有需要再次手术的膝关节均为后位撕裂行修补术。对于行修补术的膝关节，其再次手术的需要与手术修复之间存在显著相关性（ =.0048）。外侧盘状半月板患者病例系列中也观察到较高的周围不稳定率。
盘状内侧半月板患者的临床表现和治疗方法与外侧盘状半月板患者相似。盘状内侧半月板膝关节也表现出不稳定，归因于周围不足和后撕裂。超过一半的盘状内侧半月板膝关节有撕裂，行撕裂修补术的膝关节比未行修补术的膝关节更常见再次手术。
