Campbell Abigail L, Pace J Lee, Mandelbaum Bert R
Kaiser Permanente West Los Angeles, Los Angeles, CA, USA.
NYU Langone Health, Orthopedics, New York, NY, USA.
Curr Rev Musculoskelet Med. 2023 Apr;16(4):154-161. doi: 10.1007/s12178-023-09824-4. Epub 2023 Mar 15.
Discoid lateral meniscus (DLM) is a well-known meniscus variant, and comprises excess and thickened meniscal tissue, altered collagen ultrastructure, and peripheral instability. This article presents a comprehensive review on current knowledge of DLM, focusing on pathology in parallel with surgical techniques and outcomes.
A paradigm shift in surgical management of DLM is taking place as knee surgeons are seeing more patients with long-term sequelae of partial lateral meniscectomy, the standard treatment for DLM for many years. Surgical treatment has evolved alongside the understanding of DLM pathology. A new classification system has been proposed and optimal surgical techniques described in recent years. This article highlights up-to-date evidence and techniques in management of both acute DLM tears and joint restoration following subtotal meniscectomy for DLM. Surgical management of DLM must be tailored to individual pathology, which is variable within the diagnosis of DLM. We present an algorithm for management of DLM and discuss future directions for the understanding and treatment of this debilitating condition.
盘状外侧半月板(DLM)是一种众所周知的半月板变异体,由多余且增厚的半月板组织、改变的胶原超微结构以及周边不稳定组成。本文对DLM的当前知识进行全面综述,重点关注其病理与手术技术及结果。
随着膝关节外科医生见到越来越多接受多年来DLM标准治疗——部分外侧半月板切除术——后出现长期后遗症的患者,DLM的手术治疗正在发生范式转变。手术治疗随着对DLM病理的理解而不断发展。近年来已提出一种新的分类系统并描述了最佳手术技术。本文重点介绍急性DLM撕裂以及DLM次全切除术后关节修复的最新管理证据和技术。DLM的手术管理必须根据个体病理情况进行调整,而在DLM的诊断范围内,个体病理情况存在差异。我们提出一种DLM管理算法,并讨论这种致残性疾病在理解和治疗方面的未来方向。