Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2011

01-11-2011 | Knee

Horizontal cleavage tear of discoid medial meniscus diagnosed on MRI and treated with arthroscopic partial resection

Authors: Michael H. Elvey, Sujith Konan, Charles V. House, Rahul V. Patel

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2011

Login to get access

Abstract

Purpose

To provided an evidence-based summarisation of the discoid medial meniscus in conjunction with a case report describing a novel management approach which includes MRI-assisted pre-operative planning and a limited meniscal resection.

Methods

Case report and structured literature review of Medline referenced articles from 1941 to 2011.

Results

Forty-one papers describing 61 patients and 82 discoid medial menisci were identified. Data extracted included patient demographics, diagnostic techniques, operative interventions, and associated pathological findings. These findings were compared with the index case report. A new technique involving MRI-assisted pre-operative planning and limited meniscal resection is described.

Conclusion

The discoid medial meniscus remains a rare abnormality with significant associated morbidity. It continues to provide physicians with both diagnostic and interventional challenges. MRI-assisted pre-operative planning can provide surgeons with the opportunity to plan for limited resection so as to maximally lessen the probability of early-onset osteoarthritis which may result from loss of meniscal tissue.

Level of evidence

IV.
Literature
1.
go back to reference Adriani E, Liccardo M, Mariani PP (1993) Discoid medial meniscus: report of a case treated by arthroscopy. Knee Surg Sports Traumatol Arthrosc 1:107–109PubMedCrossRef Adriani E, Liccardo M, Mariani PP (1993) Discoid medial meniscus: report of a case treated by arthroscopy. Knee Surg Sports Traumatol Arthrosc 1:107–109PubMedCrossRef
2.
go back to reference Ahn JH, Choi SH, Lee YS, Yoo JC, Chang MJ, Bae S, Bae YR (2011) Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 19:158–164PubMedCrossRef Ahn JH, Choi SH, Lee YS, Yoo JC, Chang MJ, Bae S, Bae YR (2011) Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 19:158–164PubMedCrossRef
3.
go back to reference Ahn JH, Yoo JC, Wang JH, Lee YS, Yim HS, Chang MJ (2011) Anomalies of the discoid medial meniscus. Orthopedics 34(2) Ahn JH, Yoo JC, Wang JH, Lee YS, Yim HS, Chang MJ (2011) Anomalies of the discoid medial meniscus. Orthopedics 34(2)
4.
go back to reference Aichroth PM, Patel DV, Marx CL (1991) Congenital discoid lateral meniscus in children. A following study and evolution of management. J Bone Joint Surg Br 73:932–936PubMed Aichroth PM, Patel DV, Marx CL (1991) Congenital discoid lateral meniscus in children. A following study and evolution of management. J Bone Joint Surg Br 73:932–936PubMed
5.
go back to reference Akgün I, Heybeli N, Bagatur E, Karadeniz N (1998) Bilateral discoid medial menisci: an adult patient with symmetrical radial tears in both knees. Arthroscopy 14:512–517PubMedCrossRef Akgün I, Heybeli N, Bagatur E, Karadeniz N (1998) Bilateral discoid medial menisci: an adult patient with symmetrical radial tears in both knees. Arthroscopy 14:512–517PubMedCrossRef
6.
go back to reference Atay OA, Doral MN, Aydingoz U, Leblebicioglu G (2001) Bilateral discoid medial menisci: association with bone changes in the tibia. Knee Surg Sports Traumatol Arthrosc 9:217–220PubMedCrossRef Atay OA, Doral MN, Aydingoz U, Leblebicioglu G (2001) Bilateral discoid medial menisci: association with bone changes in the tibia. Knee Surg Sports Traumatol Arthrosc 9:217–220PubMedCrossRef
7.
go back to reference Auge WK 2nd, Kaeding CC (1994) Bilateral discoid medial menisci with extensive intrasubstance cleavage tears: MRI and arthroscopic correlation. Arthroscopy 10:313–318PubMedCrossRef Auge WK 2nd, Kaeding CC (1994) Bilateral discoid medial menisci with extensive intrasubstance cleavage tears: MRI and arthroscopic correlation. Arthroscopy 10:313–318PubMedCrossRef
8.
go back to reference Bardeen CR, Lewis WH (1901) Development of the limbs, body wall and back in man. Am J Anat 1:1CrossRef Bardeen CR, Lewis WH (1901) Development of the limbs, body wall and back in man. Am J Anat 1:1CrossRef
9.
go back to reference Bellelli A (1996) Bilateral medial discoid meniscus: a case assessed with magnetic resonance. Radiol Med 92:310–312PubMed Bellelli A (1996) Bilateral medial discoid meniscus: a case assessed with magnetic resonance. Radiol Med 92:310–312PubMed
10.
go back to reference Berson BL, Hermann G (1979) Torn discoid menisci of the knee in adults. Four case reports. J Bone Joint Surg Am 61:303–304PubMed Berson BL, Hermann G (1979) Torn discoid menisci of the knee in adults. Four case reports. J Bone Joint Surg Am 61:303–304PubMed
11.
go back to reference Blacksin MF, Greene B, Botelho G (1992) Bilateral discoid medial menisci diagnosed by magnetic resonance imaging: a case report. Clin Orthop Relat Res 285:214–216PubMed Blacksin MF, Greene B, Botelho G (1992) Bilateral discoid medial menisci diagnosed by magnetic resonance imaging: a case report. Clin Orthop Relat Res 285:214–216PubMed
12.
go back to reference Cave EF, Staples OS (1941) Congenital discoid meniscus: a cause of internal impingement of the knee. Am J Surg 54:371–376CrossRef Cave EF, Staples OS (1941) Congenital discoid meniscus: a cause of internal impingement of the knee. Am J Surg 54:371–376CrossRef
13.
go back to reference Choi NH, Kim NM, Kin HJ (2001) Medial and lateral discoid meniscus in the same knee. Arthroscopy 17:E9PubMedCrossRef Choi NH, Kim NM, Kin HJ (2001) Medial and lateral discoid meniscus in the same knee. Arthroscopy 17:E9PubMedCrossRef
14.
go back to reference Clark CR, Ogden JA (1983) Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am 65:538–547PubMed Clark CR, Ogden JA (1983) Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am 65:538–547PubMed
15.
go back to reference Comba D, Quaglia F, Magliano G (1985) Massive discoid medial meniscus. A case report. Acta Orthop Scand Aug 56:340–341CrossRef Comba D, Quaglia F, Magliano G (1985) Massive discoid medial meniscus. A case report. Acta Orthop Scand Aug 56:340–341CrossRef
16.
go back to reference Dickason JM, Del Pizzo W, Blazina ME, Fox JM, Friedman MJ, Snyder SJ (1982) A series of ten discoid medial menisci. Clin Orthop Relat Res 168:75–79PubMed Dickason JM, Del Pizzo W, Blazina ME, Fox JM, Friedman MJ, Snyder SJ (1982) A series of ten discoid medial menisci. Clin Orthop Relat Res 168:75–79PubMed
17.
go back to reference Dickout SC, Delee JC (1982) The discoid lateral-meniscus syndrome. J Bone Joint Surg Am 64:1068–1073 Dickout SC, Delee JC (1982) The discoid lateral-meniscus syndrome. J Bone Joint Surg Am 64:1068–1073
18.
20.
go back to reference Franceschi F, Longo UG, Ruzzini L, Simoni P, Zobel BB, Denaro V (2007) Bilateral complete discoid medial meniscus combined with posterior cyst formation. Knee Surg Sports Traumatol Arthrosc 15:266–268PubMedCrossRef Franceschi F, Longo UG, Ruzzini L, Simoni P, Zobel BB, Denaro V (2007) Bilateral complete discoid medial meniscus combined with posterior cyst formation. Knee Surg Sports Traumatol Arthrosc 15:266–268PubMedCrossRef
21.
go back to reference Hayashi LK, Yamaga H, Ida K, Miura T (1988) Arthroscopic meniscectomy for discoid lateral meniscus in children. J Bone Joint Surg Am 70:1495–1500PubMed Hayashi LK, Yamaga H, Ida K, Miura T (1988) Arthroscopic meniscectomy for discoid lateral meniscus in children. J Bone Joint Surg Am 70:1495–1500PubMed
22.
go back to reference Ikeuchi H (1982) Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results. Clin Orthop 167:19–28PubMed Ikeuchi H (1982) Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results. Clin Orthop 167:19–28PubMed
23.
go back to reference Jeannopoulos CL (1950) Observations on discoid menisci. J Bone Joint Surg Am 32-A:649–652 Jeannopoulos CL (1950) Observations on discoid menisci. J Bone Joint Surg Am 32-A:649–652
24.
go back to reference Kaplan EB (1957) Discoid lateral meniscus of the knee joint. J Bone Joint Surg Am 39:77–87PubMed Kaplan EB (1957) Discoid lateral meniscus of the knee joint. J Bone Joint Surg Am 39:77–87PubMed
25.
go back to reference Kim SJ, Choi CH (1996) Bilateral complete discoid medial menisci combined with anomalous insertion and cyst formation. Arthroscopy 12:112–115PubMedCrossRef Kim SJ, Choi CH (1996) Bilateral complete discoid medial menisci combined with anomalous insertion and cyst formation. Arthroscopy 12:112–115PubMedCrossRef
26.
go back to reference Kim SJ, Kwun JD, Jung KA, Kim JM (2005) Arthroscopic excision of the symptomatic discoid medial meniscus in one piece: a surgical technique. Arthroscopy 21:1515PubMed Kim SJ, Kwun JD, Jung KA, Kim JM (2005) Arthroscopic excision of the symptomatic discoid medial meniscus in one piece: a surgical technique. Arthroscopy 21:1515PubMed
27.
go back to reference Kim SJ, Lubis A (2010) Medial and lateral discoid menisci: a case report. Sports Med Arthrosc Rehabil Ther Technol 2:21PubMedCrossRef Kim SJ, Lubis A (2010) Medial and lateral discoid menisci: a case report. Sports Med Arthrosc Rehabil Ther Technol 2:21PubMedCrossRef
28.
go back to reference Kim SJ, Seo YJ (2006) Bilateral discoid medial menisci: incomplete type in one knee and complete type in opposite knee. Knee 13:255–257PubMedCrossRef Kim SJ, Seo YJ (2006) Bilateral discoid medial menisci: incomplete type in one knee and complete type in opposite knee. Knee 13:255–257PubMedCrossRef
29.
go back to reference Kim SJ, Yoo JH, Kim HK (1996) Arthroscopic one-piece excision technique for the treatment of symptomatic lateral discoid meniscus. Arthroscopy 12:752–755PubMedCrossRef Kim SJ, Yoo JH, Kim HK (1996) Arthroscopic one-piece excision technique for the treatment of symptomatic lateral discoid meniscus. Arthroscopy 12:752–755PubMedCrossRef
30.
go back to reference Komatsu T, Hashimoto Y, Sakanaka H, Gotani H, Yamano Y (2007) Bilateral discoid medial menisci accompanied by distal arthrogryposis: a case report. Knee Surg Sports Traumatol Arthrosc 15:424–426PubMedCrossRef Komatsu T, Hashimoto Y, Sakanaka H, Gotani H, Yamano Y (2007) Bilateral discoid medial menisci accompanied by distal arthrogryposis: a case report. Knee Surg Sports Traumatol Arthrosc 15:424–426PubMedCrossRef
31.
go back to reference Lee BI, Lee YS, Kwon SW, Choi SW, Cho KH, Kwon YJ (2007) Bilateral symptomatic discoid medial meniscus: report of three cases. Knee Surg Sports Traumatol Arthrosc 15:739–743PubMedCrossRef Lee BI, Lee YS, Kwon SW, Choi SW, Cho KH, Kwon YJ (2007) Bilateral symptomatic discoid medial meniscus: report of three cases. Knee Surg Sports Traumatol Arthrosc 15:739–743PubMedCrossRef
32.
go back to reference Lowenberg DW, Feldman ML (1993) Magnetic resonance imaging diagnosis of discoid medial meniscus. Arthroscopy 9:704–706PubMedCrossRef Lowenberg DW, Feldman ML (1993) Magnetic resonance imaging diagnosis of discoid medial meniscus. Arthroscopy 9:704–706PubMedCrossRef
33.
go back to reference Mcdermott LJ (1943) Development of the human knee joint. Arch Surg 46:705–719 Mcdermott LJ (1943) Development of the human knee joint. Arch Surg 46:705–719
34.
35.
go back to reference Min BH, Ha HK, Khang SY (2001) Medial discoid meniscus completely coalesced with the anterior cruciate ligament. Arthroscopy 17:E27PubMedCrossRef Min BH, Ha HK, Khang SY (2001) Medial discoid meniscus completely coalesced with the anterior cruciate ligament. Arthroscopy 17:E27PubMedCrossRef
36.
go back to reference Murdoch G (1956) Congenital discoid medial semilunar cartilage. J Bone Joint Surg Br 38-B:564 Murdoch G (1956) Congenital discoid medial semilunar cartilage. J Bone Joint Surg Br 38-B:564
37.
go back to reference Narvekar A, Acharya A, Shroff M (1999) Bilateral discoid medial menisci with abnormal attachment to the anterior cruciate ligament–a case report. Acta Orthop Scand 70:387–389PubMedCrossRef Narvekar A, Acharya A, Shroff M (1999) Bilateral discoid medial menisci with abnormal attachment to the anterior cruciate ligament–a case report. Acta Orthop Scand 70:387–389PubMedCrossRef
38.
go back to reference Nathan PA, Cole SC (1969) Discoid meniscus. A clinical and pathologic study. Clin Orthop 64:107 Nathan PA, Cole SC (1969) Discoid meniscus. A clinical and pathologic study. Clin Orthop 64:107
39.
go back to reference Ogata K (1997) Arthroscopic technique: two-piece excision of discoid meniscus. Arthroscopy 13:666–670PubMedCrossRef Ogata K (1997) Arthroscopic technique: two-piece excision of discoid meniscus. Arthroscopy 13:666–670PubMedCrossRef
40.
go back to reference Papadopoulos A, Karathanasis A, Kirkos JM, Kapetanos GA (2009) Epidemiologic, clinical and arthroscopic study of the discoid meniscus variant in Greek population. Knee Surg Sports Traumatol Arthrosc 17:600–606PubMedCrossRef Papadopoulos A, Karathanasis A, Kirkos JM, Kapetanos GA (2009) Epidemiologic, clinical and arthroscopic study of the discoid meniscus variant in Greek population. Knee Surg Sports Traumatol Arthrosc 17:600–606PubMedCrossRef
41.
go back to reference Papadopoulos A, Kirkos JM, Kapetanos GA (2009) Histomorphologic study of discoid meniscus. Arthroscopy 25:262–268PubMedCrossRef Papadopoulos A, Kirkos JM, Kapetanos GA (2009) Histomorphologic study of discoid meniscus. Arthroscopy 25:262–268PubMedCrossRef
42.
go back to reference Patel D, Dimakopoulos P, Denoncourt P (1986) Bucket handle tear of a discoid medial meniscus. Arthroscopic diagnosis–partial excision. A case report. Orthopedics 9:607–608PubMed Patel D, Dimakopoulos P, Denoncourt P (1986) Bucket handle tear of a discoid medial meniscus. Arthroscopic diagnosis–partial excision. A case report. Orthopedics 9:607–608PubMed
43.
go back to reference Pinar H, Akseki D, Karaoğlan O, Ozkan M, Uluç E (2000) Bilateral discoid medial menisci. Arthroscopy 16:96–101PubMedCrossRef Pinar H, Akseki D, Karaoğlan O, Ozkan M, Uluç E (2000) Bilateral discoid medial menisci. Arthroscopy 16:96–101PubMedCrossRef
44.
go back to reference Resnick D, Goergen TG, Kaye JJ, Ghelman B, Woody PR (1976) Discoid medial meniscus. Radiology 121:575–576PubMed Resnick D, Goergen TG, Kaye JJ, Ghelman B, Woody PR (1976) Discoid medial meniscus. Radiology 121:575–576PubMed
45.
go back to reference Riachi E, Pahres A (1963) An unusual deformity of the medial semilunar cartilage. J Bone Joint Surg Br 45-B:146–147 Riachi E, Pahres A (1963) An unusual deformity of the medial semilunar cartilage. J Bone Joint Surg Br 45-B:146–147
46.
go back to reference Richmond DA (1958) Two cases of discoid medial cartilage. J Bone Joint Surg Br 40-B:268–269 Richmond DA (1958) Two cases of discoid medial cartilage. J Bone Joint Surg Br 40-B:268–269
47.
go back to reference Ross JA, Tough IC, English TA (1958) Congenital discoid cartilage. Report of a case of discoid medial cartilage with an embryological note. J Bone Joint Surg Br 40-B:262–267 Ross JA, Tough IC, English TA (1958) Congenital discoid cartilage. Report of a case of discoid medial cartilage with an embryological note. J Bone Joint Surg Br 40-B:262–267
48.
go back to reference Schonholtz GJ, Koenig TM, Prince A (1993) Bilateral discoid medial menisci: a case report and literature review. Arthroscopy 9:315–317PubMedCrossRef Schonholtz GJ, Koenig TM, Prince A (1993) Bilateral discoid medial menisci: a case report and literature review. Arthroscopy 9:315–317PubMedCrossRef
49.
go back to reference Silverman JM, Mink JH, Deutsch AL (1989) Discoid menisci of the knee: MR imaging appearance Radiology 173(2):351–354 Silverman JM, Mink JH, Deutsch AL (1989) Discoid menisci of the knee: MR imaging appearance Radiology 173(2):351–354
50.
go back to reference Smillie IS (1948) The congenital discoid meniscus. J Bone Joint Surg Br 30-B:671–682 Smillie IS (1948) The congenital discoid meniscus. J Bone Joint Surg Br 30-B:671–682
51.
go back to reference Sorren A (1985) On the etiology of congenital malformation of the meniscus. Arch Orthop Trauma Surg 104:283–288CrossRef Sorren A (1985) On the etiology of congenital malformation of the meniscus. Arch Orthop Trauma Surg 104:283–288CrossRef
52.
go back to reference Spicer DD (1999) Radiologic case study. Discoid medial meniscus. Orthopaedics 22:45545–45546 Spicer DD (1999) Radiologic case study. Discoid medial meniscus. Orthopaedics 22:45545–45546
53.
go back to reference Stern A, Hallel T (1988) Medial discoid meniscus with cyst formation in a child. J Pediatr Orthop 8:471–473PubMedCrossRef Stern A, Hallel T (1988) Medial discoid meniscus with cyst formation in a child. J Pediatr Orthop 8:471–473PubMedCrossRef
54.
55.
go back to reference Vidyadhara S, Rao SK, Rao S (2006) Discoid medial meniscus. Varied presentation of 3 knees. Saudi Med J 27:888–891PubMed Vidyadhara S, Rao SK, Rao S (2006) Discoid medial meniscus. Varied presentation of 3 knees. Saudi Med J 27:888–891PubMed
56.
go back to reference Washington ER 3rd, Root L, Liener UC (1995) Discoid lateral meniscus in children. Long-term follow-up after excision. J Bone Joint Surg Am 77:1357–1361PubMed Washington ER 3rd, Root L, Liener UC (1995) Discoid lateral meniscus in children. Long-term follow-up after excision. J Bone Joint Surg Am 77:1357–1361PubMed
57.
go back to reference Watanabe M (1974) Arthroscopy of the knee joint. In: Helfet AJ (ed) Disorders of the knee. Lippincott, Philadelphia, pp 145–159 Watanabe M (1974) Arthroscopy of the knee joint. In: Helfet AJ (ed) Disorders of the knee. Lippincott, Philadelphia, pp 145–159
58.
go back to reference Weiner B, Rosenberg N (1974) Discoid medial meniscus: association with bone changes in the tibia. A case report. J Bone Joint Surg Am 56:171–173PubMed Weiner B, Rosenberg N (1974) Discoid medial meniscus: association with bone changes in the tibia. A case report. J Bone Joint Surg Am 56:171–173PubMed
59.
go back to reference Yáñez-Acevedo A (2001) Bilateral discoid lateral menisci and Unilateral discoid medial menisci. Arthroscopy 17:772–775PubMedCrossRef Yáñez-Acevedo A (2001) Bilateral discoid lateral menisci and Unilateral discoid medial menisci. Arthroscopy 17:772–775PubMedCrossRef
Metadata
Title
Horizontal cleavage tear of discoid medial meniscus diagnosed on MRI and treated with arthroscopic partial resection
Authors
Michael H. Elvey
Sujith Konan
Charles V. House
Rahul V. Patel
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1487-z

Other articles of this Issue 11/2011

Knee Surgery, Sports Traumatology, Arthroscopy 11/2011 Go to the issue