Summary A discoid meniscus is the abnormal development of the meniscus leading to a hypertrophic and discoid shaped meniscus. Diagnosis can be suspected on radiographs with (squaring of lateral condyle with cupping of lateral tibial plateau) but require MRI for confirmation (3 or more 5mm sagittal images with meniscal continuity). Treatment is generally observation for patients who are asymptomatic. Arthroscopic meniscectomy and saucerization may be indicated for patients with continued pain and mechanical symptoms. Epidemiology Incidence common present in 3-5% of population Anatomic location usually lateral meniscus involved 25% bilateral Etiology Pathophysiology failure of apoptosis in utero Classification Watanabe Classification Type I Complete Type II Incomplete Type III Wrisberg (lack of posterior meniscotibial attachment to tibia) Presentation Symptoms pain, clicking, mechanical locking often becomes symptomatic in adolescence Physical exam mechanical symptoms most pronounced in extension Imaging Radiographs recommended views AP and lateral of knee findings widened joint space (up to 11mm) squaring of lateral condyle cupping of lateral tibial plateau hypoplastic lateral intercondylar spine MRI indications study of choice for suspected symptomatic meniscal pathology findings diagnosis can be made with 3 or more 5mm sagittal images with meniscal continuity ("bow-tie sign") sagittal MRI will show abnormally thick and flat meniscus coronal MRI will show thick and flat meniscal tissue extending across entire lateral compartment Symptomatic cases may reveal underlying meniscus tear Treatment Nonoperative observation indications asymptomatic discoid meniscus without tears Operative partial meniscectomy and saucerization indications pain and mechanical symptoms meniscal tear or meniscal detachment technique obtain anatomic looking meniscus with debridement repair meniscus if detached (Wrisberg variant) meniscal instability is frequently present recent literature suggest anterior horn instability is most common
Technique Guide Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC. Discoid Lateral Meniscus Saucerization and Stabilization Orthobullets Team Knee & Sports - Discoid Meniscus
QUESTIONS 1 of 19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (SBQ16SM.92) A 13-year-old girl presents with lateral knee pain after a twisting injury during basketball. Physical examination reveals mild effusion, lateral sided tenderness, and range of motion from 10-85 degrees without any signs of instability. Imaging studies are depicted in Figures A and B. Which of the following is most accurate about the etiology of her diagnosis? QID: 212118 FIGURES: A B Type & Select Correct Answer 1 Softening of the overlying articular cartilage with intact articular surface 5% (56/1147) 2 Mutation in COL5A1 gene 2% (27/1147) 3 Failure of apoptosis during in-utero development 74% (845/1147) 4 Landing biomechanics and neuromuscular activation patterns 13% (149/1147) 5 Relative quadriceps strength over hamstrings 5% (52/1147) L 3 Question Complexity E Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (SBQ16SM.13) A 12-year-old basketball player reports frequent and moderately painful popping in his left knee during his games. His symptoms have remained persistent and both he and his parents are concerned as this limits his performance. He is evaluated and the decision is made to proceed with arthroscopic saucerization. Which of the following is true of his pathology? QID: 211249 Type & Select Correct Answer 1 Incomplete is more common than complete type 28% (655/2348) 2 Instability of the meniscus is uncommon 8% (196/2348) 3 Long-term degenerative changes are similar between arthroscopic saucerization, partial, and complete meniscectomy 6% (137/2348) 4 Saucerization with repair results in inferior clinical outcomes compared to saucerization alone 6% (141/2348) 5 A 6-8mm peripheral rim is recommended following saucerization 51% (1198/2348) L 4 Question Complexity A Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (SBQ13PE.9) A 6-year-old boy complains of a 'clunking' sensation in his left knee. He has no associated pain and denies trauma. He can elicit the sensation when moving his knee from flexion into full extension. He is otherwise healthy, with no birth or developmental issues. On examination, there is a palpable clunk felt over the anterior knee through range of motion. There is no obvious instability or tenderness and he had normal patellar tracking. An AP radiograph of the knee is shown in Figure A. What would be the most likely diagnosis? QID: 4943 FIGURES: A Type & Select Correct Answer 1 Agenesis of the anterior cruciate ligament 2% (113/4585) 2 Thickened medial plica 22% (994/4585) 3 Grade IV chondral flap 1% (65/4585) 4 Pigmented villonodular synovitis 1% (43/4585) 5 Abnormal meniscal morphology 73% (3326/4585) L 3 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic (SBQ13PE.10) Which statement is true regarding discoid menisci? QID: 4947 Type & Select Correct Answer 1 Most commonly involves the medial meniscus 5% (184/3837) 2 Bilateral in >75% of cases 6% (231/3837) 3 Asymptomatic discoid meniscus should undergo saucerization 1% (38/3837) 4 Radiographs will commonly show a hyperplastic lateral intercondylar spine 3% (128/3837) 5 Radiographs will commonly show squaring of affected condyle with cupping of tibial plateau 84% (3228/3837) L 2 Question Complexity B Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ07.129) An 11-year-old soccer player presents with a 6 month history of snapping and discomfort along the lateral joint line of the knee. Examination shows a 10 degree loss of active extension. An AP radiographs is shown in Figure A. Sequential sagittal MRI images of the lateral compartment of the knee are shown in Figure B. What is the most appropriate course of action? QID: 790 FIGURES: A B Type & Select Correct Answer 1 Physical therapy with a focus on concentric knee strengthening 11% (267/2494) 2 Non-weightbearing for 6 weeks 3% (70/2494) 3 Arthroscopic saucerization of the lateral meniscus and/or meniscal repair 84% (2093/2494) 4 Open lateral meniscectomy 1% (19/2494) 5 Arthroscopic microfracture treatment of the defect on the lateral femoral condyle 1% (30/2494) L 2 Question Complexity C Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 3 Review Tested Concept Review Full Topic (OBQ05.166) An 8-year-old boy was playing at school and took a direct blow to his knee causing pain and swelling. His pediatrician ordered an MRI which is shown in Figure A. The patient was referred to your office for a consultation. He denies any past history of pain, clicking, or locking. His knee exam is unremarkable. Radiographs of the knee in your office are normal. What course of action will you recommend? QID: 1052 FIGURES: A Type & Select Correct Answer 1 Surgical debridement and repair 4% (128/3036) 2 Ligamentous reconstruction 1% (28/3036) 3 Casting in 45 degrees of flexion 2% (72/3036) 4 Knee immobilizer and non weight bearing for 6 weeks 5% (146/3036) 5 Observation 87% (2651/3036) L 1 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 5 Review Tested Concept Review Full Topic
All Videos (1) Podcasts (2) Login to View Community Videos Login to View Community Videos Saucerization of a discoid lateral meniscus David Abbasi Knee & Sports - Discoid Meniscus E 3/10/2012 6472 views 1.6 (21) Knee & Sports | Discoid Meniscus Knee & Sports - Discoid Meniscus Listen Now 13:12 min 10/15/2019 197 plays 5.0 (3) Knee & SportsāMeniscal Injuries & Discoid Meniscus (ft. Dr. Raymond H. Kim) Team Orthobullets 4 Knee & Sports - Discoid Meniscus Listen Now 6:33 min 10/18/2019 157 plays 5.0 (2)