Trisolino Giovanni, Stallone Stefano, Grassi Alberto, Olivotto Eleonora, Battistelli Michela, Zarantonello Paola, Gallone Giovanni, Ferrari Daniele, Di Gennaro Giovanni Luigi, Zaffagnini Stefano
Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Ann Jt. 2022 Oct 15;7:38. doi: 10.21037/aoj-21-31. eCollection 2022.
The discoid lateral meniscus (DLM) is a congenital abnormality of the meniscal shape, characterized by a typical central hypertrophy and a diameter larger than a regular meniscus, potentially leading to knee pain and symptoms, especially in children. The present study provides an update and a general review of this uncommon meniscal pathology. The incidence of discoid meniscus is about 0.4-17% for the lateral and 0.1-0.3% for the medial, although, being often asymptomatic, the true prevalence is unknown. We aim to enhance awareness on this subject to medical care provider.
A literature search was performed on PubMed, including articles written in English until October 2021.
The articles regarding etiology, diagnosis and management of DLM in children or in patients younger than 18 years were reviewed using the narrative approach.
Recent literature has shown that DLM is one of the most frequent congenital anomalies of the knee encountered during childhood. While asymptomatic children with incidental finding can be managed nonoperatively, symptomatic painful DLM should be addressed surgically, restoring typical anatomy using saucerization, tear repair, and stable fixation of the meniscus. The risk of osteoarthritis progression seems to be higher in children with operated DLM, imposing prolonged follow-up and cartilage preserving strategies for these patients.
盘状外侧半月板（DLM）是半月板形状的先天性异常，其特征为典型的中央肥厚且直径大于正常半月板，可能导致膝关节疼痛及症状，尤其是在儿童中。本研究提供了关于这种不常见半月板病变的最新情况及综合综述。盘状半月板的发病率外侧约为0.4 - 17%，内侧约为0.1 - 0.3%，不过由于其常无症状，真实患病率尚不清楚。我们旨在提高医疗服务提供者对该主题的认识。
在PubMed上进行文献检索，包括截至2021年10月用英文撰写的文章。
采用叙述性方法回顾了关于儿童或18岁以下患者DLM的病因、诊断和治疗的文章。
最近的文献表明，DLM是儿童期最常见的膝关节先天性异常之一。对于偶然发现的无症状儿童可采取非手术治疗，而有症状疼痛的DLM应进行手术治疗，通过半月板修整、撕裂修复和半月板稳定固定来恢复典型解剖结构。接受手术治疗的儿童发生骨关节炎进展的风险似乎更高，因此需要对这些患者进行长期随访并采取保留软骨的策略。
