Introduction Abnormal development of the meniscus leads to a hypertrophic and discoid shaped meniscus discoid meniscus is larger than usual also referred to as "popping knee syndrome" Epidemiology incidence present in 3-5% of population location usually lateral meniscus involved 25% bilateral Classification Watanabe Classification Type I • Incomplete Type II • Complete 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 with 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 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)
Technique Guide Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC. Discoid Lateral Meniscus Saucerization and Stabilization Orthobullets Team Knee & Sports - Discoid Meniscus
QUESTIONS 1 of 12 1 2 3 4 5 6 7 8 9 10 11 12 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 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 (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? Review Topic QID: 1052 FIGURES: A 1 Surgical debridement and repair 4% (83/2011) 2 Ligamentous reconstruction 1% (12/2011) 3 Casting in 45 degrees of flexion 2% (41/2011) 4 Knee immobilizer and non weight bearing for 6 weeks 5% (93/2011) 5 Observation 88% (1774/2011) ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (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? Review Topic QID: 790 FIGURES: A B 1 Physical therapy with a focus on concentric knee strengthening 12% (135/1126) 2 Non-weightbearing for 6 weeks 4% (42/1126) 3 Arthroscopic saucerization of the lateral meniscus and/or meniscal repair 81% (917/1126) 4 Open lateral meniscectomy 1% (12/1126) 5 Arthroscopic microfracture treatment of the defect on the lateral femoral condyle 1% (14/1126) ML 2 Select Answer to see Preferred Response PREFERRED RESPONSE 3 Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK
Upgrade to View Premium Videos Upgrade to View Premium Videos Saucerization of a discoid lateral meniscus David Abbasi Knee & Sports - Discoid Meniscus 3/10/2012 5098 views