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临床表现与关节镜治疗外侧盘状半月板 III 型可动性Wrisberg 变异:9 例报告。

Clinical presentation and arthroscopic treatment of hypermobile Type III Wrisberg variant of lateral discoid meniscus: Report of nine cases.

机构信息

IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

出版信息

Knee. 2023 Aug;43:224-240. doi: 10.1016/j.knee.2023.02.004. Epub 2023 Apr 3.

Abstract

BACKGROUND

The aim of the present study was to document a series of patients with meniscal hypermobility due to a Type III Wrisberg variant lateral discoid meniscus, describing their clinical presentation, analyzing their magnetic resonance imaging (MRI) and arthroscopic characteristics, and reporting the outcomes of an all-inside stabilization.

METHOD

Nine cases of Wrisberg variant Type III discoid lateral menisci were identified based on patient's history and clinical examination. Knee MRIs were reviewed to exclude the presence of Type I-II discoid meniscus (complete or incomplete) or bucket handle tears and general arthroscopic criteria. For the Wrisberg variant discoid lateral meniscus were applied for the final diagnosis.

RESULTS

All nine cases presented similar peculiar clinical, radiological, and arthroscopic features, which led to the diagnosis of hypermobile Wrisberg variant of lateral discoid meniscus. This rareclinical entity is responsible for suggestive symptoms such as pain, popping and knee locking; moreover, subtle but peculiar MRI and arthroscopic characteristics can be observed.

CONCLUSION

Considering the possibility of repeated dislocation and relocation, diagnosis can be challenging, and a high degree of suspicion should be used, especially in young patients, bilateral symptoms, and absence of trauma.

摘要

背景

本研究的目的是记录一系列由于 III 型 Wrisberg 变异外侧盘状半月板引起的半月板活动过度患者,描述其临床表现,分析其磁共振成像(MRI)和关节镜特征,并报告全内稳定化的结果。

方法

根据患者的病史和临床检查,确定了 9 例 Wrisberg 变异 III 型盘状外侧半月板。对膝关节 MRI 进行了回顾,以排除 I-II 型盘状半月板(完全或不完全)或桶柄状撕裂以及一般关节镜标准的存在。Wrisberg 变异盘状外侧半月板的存在用于最终诊断。

结果

所有 9 例均表现出相似的特殊临床、放射学和关节镜特征,导致外侧盘状半月板活动过度的 Wrisberg 变异诊断。这种罕见的临床实体可引起提示性症状,如疼痛、弹响和膝关节锁定;此外,还可以观察到微妙但特殊的 MRI 和关节镜特征。

结论

考虑到反复脱位和再定位的可能性,诊断具有挑战性,应高度怀疑,尤其是在年轻患者、双侧症状和无外伤的情况下。

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