Bilateral Discoid Lateral Meniscus in Knees: Evaluation of the Contralateral Knee in Patients With Symptomatic Discoid Lateral Meniscus

doi:10.1016/j.arthro.2010.02.008

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Volume 26, Issue 10, October 2010, Pages 1348-1356

https://doi.org/10.1016/j.arthro.2010.02.008 Get rights and content

Purpose

The aim of this study was to analyze, by use of magnetic resonance imaging (MRI), the contralateral discoid lateral meniscus (DLM) status of 33 patients who underwent an operation for a symptomatic DLM.

Methods

This diagnostic study included 33 consecutive patients who underwent arthroscopic surgery for a unilaterally symptomatic DLM. All patients' contralateral knees were checked with simple radiographs and MRI scans. Knees were also evaluated through physical examinations and a clinical scoring system. On the basis of the MRI findings, DLM was categorized into 3 types: normal type, incomplete discoid type, and complete discoid type. The tear patterns of the lateral menisci as imaged by radiographs and the associated chondral lesions imaged by MRI were analyzed by consensus in the bilateral knees.

Results

All but 1 of the contralateral, asymptomatic knees (97%) were diagnosed by MRI to have complete or incomplete DLM. DLMs with tears were found in the contralateral knees in 11 cases (33%), and chondral lesions were found in 4 (12%) of the complete discoid type cases. On radiography, 23 (70%) of the 33 contralateral knees showed characteristic findings of DLM. We found that 29 pairs of knees (88%) had the same lateral meniscus shape on MRI. A κ analysis showed significant and good agreement between the radiographic findings, the tear pattern of the lateral menisci, and the associated chondral lesions on MRI scans in bilateral knees.

Conclusions

DLM commonly occurs bilaterally in patients with symptomatic, unilateral surgical DLM, although this finding was applicable only to young, Asian male patients. Characteristic radiographic findings and the MRI findings of symptomatic DLM patients were significantly correlated between both knees.

Level of Evidence

Level I, testing of previously developed diagnostic criteria in a series of consecutive patients with universally applied reference gold standard.

Section snippets

Patient Demographics

Thirty-five patients underwent arthroscopic surgery for a symptomatic DLM at our institution between October 2006 and November 2008. The patients were all male soldiers of Asian descent. We prospectively collected diagnostic information for these patients, who all agreed to undergo clinical and radiographic evaluations that included MRI of the contralateral knee. All contralateral evaluations were checked during hospitalization for surgery. No financial aid was required for this study because

Operative (Symptomatic) Knee

MRI scans showed 29 CDM knees (88%) and 4 ICDM knees (12%). Meniscal tears were present in 27 knees (82%); 12 knees (36%) had a meniscal tear with a shift, and 15 knees (45%) had a meniscal tear without a shift. On the basis of our MRI classification scheme, 6 knees were classified as antero-central shift type, 3 were postero-central shift type, 3 were central shift type, and 12 had no shift type. Among these 12 non-shifting menisci, 8 horizontal cleavage tears, 4 complex tears, and 3 radial

Discussion

We have frequently observed DLM bilaterality in DLM patients.²¹ This led us to wonder how many patients who are diagnosed with a unilateral DLM also have a contralateral DLM. Few reports have described the prevalence of bilaterality in DLM patients, and to our knowledge, MRI has not previously been used to determine the status of the nonoperative knee of unilaterally symptomatic DLM patients. We found that 97% of patients with a unilateral DLM had a complete- or incomplete-type DLM in the

Conclusions

DLM commonly occurs bilaterally in patients with symptomatic, unilateral surgical DLM, although this finding was applicable only to young Asian male patients. Characteristic radiographic findings and the MRI findings of symptomatic DLM patients were significantly correlated between both knees.

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: The authors report no conflict of interest.

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Original ArticleBilateral Discoid Lateral Meniscus in Knees: Evaluation of the Contralateral Knee in Patients With Symptomatic Discoid Lateral Meniscus

Purpose

Methods

Results

Conclusions

Level of Evidence

Section snippets

Patient Demographics

Operative (Symptomatic) Knee

Discussion

Conclusions

Arthroscopy

Arthroscopy

Arthroscopy

Arthroscopy

Arthroscopy

Eur J Radiol

Magn Reson Imaging

Arthroscopy

Arthroscopy

Injury

Arthroscopic treatment of the discoid lateral meniscusTechnique and long-term results

Clin Orthop Relat Res

Arthroscopic meniscectomy for discoid lateral meniscus in children and adolescents: 4.5 year follow-up

J Pediatr Orthop B

Discoid lateral meniscus and the frequency of meniscal tears

Skeletal Radiol

Discoid lateral meniscus in children: Clinical manifestations and morphology

J Pediatr Orthop

Arthroscopic partial meniscectomy for horizontal tear of discoid lateral meniscus

Knee Surg Sports Traumatol Arthrosc

Discoid lateral meniscus

Am J Knee Surg

Discoid lateral menisci in Japanese cadaver knees

Mod Rheumatol

Original Article
Bilateral Discoid Lateral Meniscus in Knees: Evaluation of the Contralateral Knee in Patients With Symptomatic Discoid Lateral Meniscus