Knee rodilla

Knee Surg Sports Traumatol Arthrosc (2009) 17:600–606 DOI 10.1007/s00167-008-0703-y

KNEE

Epidemiologic, clinical and arthroscopic study of the discoid meniscus variant in Greek population
Anestis Papadopoulos Æ Alexandros Karathanasis Æ John M. Kirkos Æ George A. Kapetanos

Received: 30 June 2008 / Accepted: 1 December 2008 / Published online: 9 January 2009 Ó Springer-Verlag 2008Abstract This retrospective study was aimed to investigate the epidemiologic, clinical and arthroscopic features of discoid meniscus variant in Greek population. We reviewed the cases of 2,132 patients who underwent knee arthroscopy between 1986 and 2004 and diagnosis of discoid lateral meniscus was established in 39 patients with mean age of 31.7 ± 9.4 years old. Incidence of the discoid lateralmeniscus variant was recorded at rate of 1.8% presenting no significant differences according to patient gender or lesion body side. Regarding the type of discoid dysmorphy, 23 cases attributed to complete type, 15 were incomplete and in one case, Wrisberg type was observed. Predictive values of the most commonly recorded physical signs in the clinical diagnosis of the discoid meniscus were analysed.Comparative evaluation of the long-term results of arthroscopic partial meniscectomy performed in patients with intact or torn discoid lateral meniscus and torn normally shaped lateral meniscus was carried out using Lysholm and IKDC scoring systems. Also, we investigated any correlation between dysmorphy type and tear pattern analysing the arthroscopic findings. Results demonstrated that thediscoid meniscus lesion represents an atypical clinical entity in adults and no significant predictive value
A. Papadopoulos Á J. M. Kirkos Á G. A. Kapetanos 3rd Orthopaedic Department, General Hospital, Aristotle University of Thessaloniki, Papageorgiou, Nea Efkarpia, 56403 Thessaloniki, Greece A. Papadopoulos Á A. Karathanasis Orthopaedic Department, 2nd Hospital IKA-ETAM of Thessaloniki, 22 N.Plastira, 55132 Kalamaria, Greece A. Papadopoulos (&) 7 Vl. Gavriilidi str., 54655 Thessaloniki, Greece e-mail: altairpap@yahoo.com

of the signs encountered in the clinical examination of the patients with discoid meniscus was observed. Clinical outcome after arthroscopic partial meniscectomy regarding the intact discoid meniscus group was superior in comparison with that of torn discoid meniscuscases. On other hand, no difference in the result of partial meniscectomy between discoid and normal lateral meniscus tear groups was found. No statistically significant relationship between the type of discoid menisci and tear pattern or incidence rate of concomitant intraarticular lesions was confirmed. Keywords Discoid lateral meniscus Á Arthroscopic partial meniscectomy Á Tear patternIntroduction Discoid meniscus represents a rare, morphologically variable anomaly with racial differences reflected in its incidence while it is more prevalent among Asians than Caucasians. In Caucasians populations, the incidence values vary between 0.4 and 5% [3, 10, 31, 44]. On other hand, higher incidence rates have been reported in Indians, 5.8% [36], Koreans, 9.1–10.5% [26] and Japanese, 16.6% [23].Since the first detailed reports by Smillie [41] about the meniscus discoid dysmorphy patterns there has been an ongoing debate with regard to the pathogeny and biomechanical behavior of the menisci with discoid variation. In 1948, Smillie suggested the embryological theory considering the lesion as atavistic and attributing the discoid shape to occasional persistence of a normal fetal stage. Later,anatomical studies did not support that theory while disc shaped fibrocatilage was not observed in any stage of the embryological development of the knee meniscus [11, 18]. In 1957, Kaplan [25] stated that the discoid shape is an

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acquired feature developed secondary to increased meniscal motion due to lack of posterior...