Partial resection of lateral discoid meniscus changes lower limb axial alignment - A retrospective cohort study.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 17. Arch Orthop Trauma Surg. 2023 Dec;143(12):7107-7114. doi: 10.1007/s00402-023-05021-7. Epub 2023 Aug 30. Wrisberg variant of the lateral discoid meniscus in children: review of the literature and presentation of case series. Megremis P(1)(2), Megremis O(3). Author information: (1)A' Orthopaedic Department, Athens General Children's Hospital P. & A. Kyriakou, Thivon and Levadias, Ambelokipi, 11527, Athens, Greece. megremispanos@yahoo.com. (2), Mati Attiki, Greece. megremispanos@yahoo.com. (3)6th Orthopaedic Department, General Peripheral Hospital of Attiki: Geniko Nosokomeio Attikes KAT, Athens, Greece. INTRODUCTION: The Wrisberg variant of the discoid lateral meniscus is a very rare disorder and is characterized by the hypermobility and instability of the meniscus caused by the absence of its posterior tibial attachment, with only its meniscofemoral junction (Wrisberg's ligament) maintained, and inserted in the posterior horn of the meniscus. As a result, the posterior horn of the lateral meniscus is mobile; often subluxing into the joint. MATERIALS AND METHODS: A total of eight skeletally immature patients with symptomatic Wrisberg variant of the discoid lateral meniscus were included in this study. Each knee was evaluated with MRI and arthroscopy. We graded unstable discoid menisci according to their discoid morphology (complete vs. incomplete), meniscal intra-substance degeneration, and the presence or absence of meniscal tears. All eight menisci were evaluated as degenerated with no meniscal tears. Five of them were evaluated as complete. Due to the severely degenerated meniscus, we considered it unnecessary to repair the detached posterior tibial ligament, so we performed a reshaping of the discoid meniscus, restoring a C-shape, excising the hypertrophied central part of the meniscus, and creating a posterior horn with a remaining rim of 6-8 mm. For evaluation of the knee function preoperatively and postoperatively we used the online International Knee Documentation Committee (IKDC) system. The purpose of this study is to emphasize the importance of MRI in identifying and revealing the unstable (Wrisberg variant) type of discoid meniscus in children. RESULTS: The mean patient age at the time of surgery was 8.25 ± 2.91 years (range 5-13 years). The average follow-up was 3.75 ± 0.46 years (range 3-4) years. The mean preoperative IKDC score was 22.37 ± 1.50 (range 21-25) points. The mean postoperative IKDC score was 80.50 ± 1.77 (range 79-84) points. CONCLUSIONS: MRI is a valuable tool in the evaluation of the shape, stability, and consistency of symptomatic discoid menisci. It is helpful for the detection of the unstable Wrisberg variant. © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. DOI: 10.1007/s00402-023-05021-7