Symptomatic Bilateral Torn Discoid Medial Meniscus Treated with Saucerization and Suture

Enrique Sevillano-Perez,Alejandro Espejo-Reina,María Josefa Espejo-Reina

doi:10.1155/2016/8487194

Enrique Sevillano-Perez, Alejandro Espejo-Reina + Show 1 more

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https://doi.org/10.1155/2016/8487194

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Abstract

Discoid meniscus is an anatomical congenital anomaly more often found in the lateral meniscus. A discoid medial meniscus is a very rare anomaly, and even more rare is to diagnose a bilateral discoid medial meniscus although the real prevalence of this situation is unknown because not all the discoid medial menisci are symptomatic and if the contralateral knee is not symptomatic then it is not usually studied. The standard treatment of this kind of pathology is partial meniscectomy. Currently the tendency is to be very conservative so suture and saucerization of a torn discoid meniscus when possible are gaining support. We present the case of a 13-year-old patient who was diagnosed with symptomatic torn bilateral discoid medial meniscus treated by suturing the tear and saucerization. To the best of our knowledge this is the first case reported of bilateral torn discoid medial meniscus treated in this manner in the same patient.

Highlights

IntroductionDiscoid meniscus is a type of meniscus with an atypical shape, thicker, covering a bigger surface of tibial plateau than a normal meniscus but more fragile which explains the higher frequency of lesions
Discoid meniscus is a type of meniscus with an atypical shape, thicker, covering a bigger surface of tibial plateau than a normal meniscus but more fragile which explains the higher frequency of lesions.The reported incidence rates for discoid lateral meniscus range from 1,2% to 5,2% being the incidence much lower for discoid medial meniscus (0,12–0,3%) [1, 2]
A complete medial discoid meniscus was found with a longitudinal tear in red zone affecting the body and posterior horn, very similar to the right knee except the upper part of the tear was not folded on the intercondylar notch it was displaced to the notch with the probe (Figure 6)

Summary

Introduction

Discoid meniscus is a type of meniscus with an atypical shape, thicker, covering a bigger surface of tibial plateau than a normal meniscus but more fragile which explains the higher frequency of lesions. The reported incidence rates for discoid lateral meniscus range from 1,2% to 5,2% being the incidence much lower for discoid medial meniscus (0,12–0,3%) [1, 2]. There are different classifications for discoid meniscus being Watanabe, the most accepted, in which discoid meniscus is classified into three different types according to the arthroscopic aspect: type I or complete, type II or incomplete, and type III or Wrisberg-ligament type in which the posterior meniscofemoral attachment is absent resulting in an unstable meniscus with hypermobility [5]. Jordan classified discoid meniscus depending on its peripheral rim stability as stable type (includes both complete and incomplete types, further divided by the presence of symptoms and tears or not) and unstable type (includes unstable normal and unstable discoid meniscus since both have the same symptoms and treatment) [6]

Case Presentation

Discussion

Conclusion