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Discoid lateral meniscus: current concepts
  1. Sachin Tapasvi1,
  2. Anshu Shekhar1,
  3. Karl Eriksson2
  1. 1Orthopaedics, Sahyadri Super Speciality Hospital Deccan Gymkhana, Pune, Maharashtra, India
  2. 2Orthopedic Surgery, Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Sachin Tapasvi, Orthopaedics, Sahyadri Super Speciality Hospital Deccan Gymkhana, Pune 411004, Maharashtra, India; stapasvi{at}gmail.com

Abstract

The discoid meniscus is a congenital morphological abnormality encountered far more commonly on the lateral than the medial side. The discoid lateral meniscus (DLM) is more prevalent in Asia with an incidence of 10%–13%, than in the Western world with an incidence of 3%–5%. DLM can be bilateral in more than 80% cases. Due to its abnormal shape and size, the discoid meniscus is prone to tearing and has an impact on gait mechanics. The discoid meniscus has deranged collagen arrangement and vascularity which can have implications for healing after a repair. Patients with a DLM may or may not be symptomatic with mechanical complaints of locking, clicking, snapping or pain. Symptoms often arise due to a tear in the body of the meniscus or a peripheral detachment. Asymptomatic patients usually do not require any treatment, while symptomatic patients who do not have locking are managed conservatively. When a peripheral detachment is present, it must be stabilised while preserving the meniscus rim to allow transmission of hoop stresses. Rehabilitation after surgery is highly individualised and return to sports is possible after more than 4 months in those undergoing a repair. The functional outcomes and onset of radiographic arthritis after saucerisation and repairing a discoid meniscus are better in the long term, compared with a subtotal meniscectomy. However, there is no compelling evidence currently favouring a repair as results deteriorate with increasing follow-up. Poor prognosis is reported in patients undergoing a total meniscectomy, a higher age at presentation and valgus malalignment.

  • meniscus
  • knee injuries
  • knee
  • arthroscopy
  • treatment outcome
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Footnotes

  • Twitter @sachintapasvi

  • Contributors ST designed the layout of the text and was involved in writing the manuscript and review of the completed paper. AS performed the literature search and wrote the manuscript. KE contributed to writing the manuscript and review of the completed paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work.

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