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      Is Open Access

      Discoid meniscus: current concepts

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          • Discoid meniscus is the most frequent congenital malformation of the menisci, and primarily affects the lateral meniscus; it is highly prevalent in the Asian population.

          • The anatomic, vascular, and ultrastructural features of the discoid meniscus make it susceptible to complex tears.

          • Discoid meniscus anomalies are described according to their shape; however, there is consensus that peripheral stability of the meniscus should also be defined.

          • Initial workup includes plain X-rays and magnetic resonance imaging, while arthroscopic evaluation confirms shape and stability of the meniscus.

          • Clinical presentation is highly variable, depending on shape, associated hypermobility, and concomitant meniscal tears.

          • Treatment seeks to re-establish typical anatomy using saucerization, tear reparation, and stable fixation of the meniscus.

          Cite this article: EFORT Open Rev 2020;5:371-379. DOI: 10.1302/2058-5241.5.190023

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          Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report.

          M E Baratz, F H Fu, R Mengato (1986)
          The role of the meniscus in load transmission across the knee has long been a subject of debate. In this study, we examined the biomechanical consequences of the operative treatments for bucket-handle and peripheral meniscal tears. Contact areas and instantaneous intraarticular pressure distributions were measured in two groups of human cadaver knees. In Group I, consisting of four knees, we created a bucket-handle tear involving the inner one-third of the meniscus, followed by partial, and then total meniscectomy. Knees were tested in an Instron testing machine after each procedure, using a 400 pound load at 0 degrees or 30 degrees flexion. Contact areas and local stresses were measured using Prescale, a pressure-sensitive film. After partial meniscectomy, contact areas decreased approximately 10%, and peak local contact stresses (PLCS) increased approximately 65%. After total meniscectomy, contact areas decreased approximately 75%, and PLCS increased approximately 235%. In Group II, consisting of three additional knees, we created a 2 cm peripheral tear of the posterior meniscal horn, followed by open repair, arthroscopic repair, segmental, and then total meniscectomy. Repair of the tear was accomplished with either vertically placed sutures by an open technique or horizontally placed sutures by an arthroscopic technique. Knees were tested in the neutral position in the Instron machine and contact areas and local stresses measured using Prescale. PLCSs and contact areas were found to be the same using either repair technique. There was, however, a 110% increase in PLCS after segmental meniscectomy of that portion of the meniscus involved in the peripheral tear.(ABSTRACT TRUNCATED AT 250 WORDS)
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            Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury.

            C Clark, J A Ogden (1983)
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              Microvasculature of the human meniscus.

              S P Arnoczky, R Warren (2015)
              The microvascular anatomy of the medial and lateral menisci of the human knee was investigated in 20 cadaver specimens by histology and tissue clearing (Spalteholz) techniques. It was found that the menisci are supplied by branches of the lateral, medial, and middle genicular arteries. A perimeniscal capillary plexus originating in the capsular and synovial tissues of the joint supplies the peripheral 10-25% of the menisci. A peripheral, vascular, synovial fringe extends a short distance over both the femoral and tibial surfaces of the menisci but does not contribute any vessels to the meniscal stroma. The posterolateral aspect of the lateral meniscus adjacent to the popliteal tendon is devoid of penetrating peripheral vessels as well as a synovial fringe. The anterior and posterior horn attachments of the menisci are covered with vascular synovial tissue and appear to have a good blood supply.
              Article 0 comments Cited 75 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): EFORT Open Rev
                Journal ID (iso-abbrev): EFORT Open Rev
                Title: EFORT Open Reviews
                Publisher: British Editorial Society of Bone and Joint Surgery
                ISSN (Electronic): 2058-5241
                Publication date Collection: July 2020
                Publication date (Electronic): 1 August 2020
                Volume: 5
                Issue: 7
                Pages: 371-379
                Affiliations
                [1 ]Universidad Austral de Chile, Valdivia, Chile
                [2 ]AO Foundation, PAEG Expert Group, Davos, Switzerland
                [3 ]Hospital Base de Valdivia, Valdivia, Chile
                [4 ]Clinica Alemana, Santiago, Chile
                [5 ]Universidad del Desarrollo, Santiago, Chile
                [6 ]Hospital Clínico Mutual de Seguridad, Santiago, Chile
                Author notes
                [*]Matías Sepúlveda, Yungay 773, App 501, Valdivia, Chile. Email: contacto@ 123456matiassepulveda.com
                Author information
                https://orcid.org/0000-0002-5394-9602
                https://orcid.org/0000-0002-6792-6145
                https://orcid.org/0000-0003-0887-9809
                https://orcid.org/0000-0002-8655-4658
                Article
                Publisher ID: 10.1302_2058-5241.5.190023
                DOI: 10.1302/2058-5241.5.190023
                PMC ID: 7407869
                PubMed ID: 32818064
                SO-VID: 438c300f-2329-432e-a0b5-58285cfab93c
                Copyright © © 2020 The author(s)
                License:

                This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.

                History
                Categories
                Subject: Paediatrics
                Subject: 9
                Subject: Knee Injuries
                Subject: Knee Joint
                Subject: Magnetic Resonance Imaging
                Subject: Menisci
                Subject: Meniscus
                Subject: Tibia
                Subject: X-Rays

                Keywords: knee injuries,knee joint,magnetic resonance imaging,menisci,meniscus,tibia,x-rays
                Data availability:
                Keywords: knee injuries, knee joint, magnetic resonance imaging, menisci, meniscus, tibia, x-rays

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