Grassi Alberto, Pizza Nicola, Macchiarola Luca, Zaffagnini Stefano
IIa Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Video J Sports Med. 2021 Jun 1;1(3):26350254211006717. doi: 10.1177/26350254211006717. eCollection 2021 May-Jun.
The Type III Wrisberg-type represents the rarest subtype of discoid meniscus. It exhibits a normal non-discoid "C"-shape with possible posterior horn hypertrophy, but meniscotibial ligaments and capsular restraints are lacking, leading to a clinical scenario of knee pain, popping, and catching due to meniscal hypermobility. Moreover, concomitant tears can be present due to repeated meniscal traumas.
Type III Wrisberg-type lateral discoid meniscus with hypermobility, dislocation, or tear.
Through standard arthroscopic portals, the meniscus is reduced in its anatomical position (if displaced). Abnormal mobility and anatomy should be noted. All-inside sutures are used in the posterior horn and body to stabilize the meniscus to the capsule and popliteus tendon. In the case of radial tears, horizontal stitches are used.
Patients are expected to return to sport approximately 4 to 5 months after the procedure with relief of pain, popping sensation, and knee locking.
Arthroscopic all-inside repair is an effective treatment for unstable and displaced Type III Wrisberg-type lateral discoid meniscus. However, the diagnosis can be challenging, especially without frank meniscal dislocation.
III型威斯伯格型盘状半月板是盘状半月板中最罕见的亚型。它呈现正常的非盘状“C”形，可能伴有后角肥大，但缺乏半月板胫骨韧带和关节囊限制，导致因半月板活动度过大而出现膝关节疼痛、弹响和卡顿的临床症状。此外，由于半月板反复受伤，可能会伴有撕裂。
具有活动度过大、脱位或撕裂的III型威斯伯格型外侧盘状半月板。
通过标准关节镜入路，将半月板复位至解剖位置（如有移位）。应注意异常的活动度和解剖结构。在后角和体部使用全内缝合，将半月板固定于关节囊和腘肌腱。对于放射状撕裂，使用水平缝合。
预计患者在术后约4至5个月可恢复运动，疼痛、弹响感和膝关节交锁症状缓解。
关节镜下全内修复是治疗不稳定和移位的III型威斯伯格型外侧盘状半月板的有效方法。然而，诊断可能具有挑战性，尤其是在没有明显半月板脱位的情况下。
