Clinical, radiologic and arthroscopic assessment and treatment of bilateral discoid lateral meniscus
Clinical, radiologic and arthroscopic assessment and treatment of bilateral discoid lateral meniscus
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DOI：
10.1007/s00167-006-0262-z
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发表时间：
2007-05-01
影响因子：
3.8
通讯作者：
Rao, P. Sripathi
中科院分区：
文献类型：
--
作者：
Rao, Sharath K.;Rao, P. Sripathi
本研究的目的是评估双侧盘状外侧半月板的临床、放射学和关节镜特征，并评估关节镜下半月板切除术的结果。在1993年1月至2004年1月期间进行的177例盘状外侧半月板关节镜检查中，12例为双侧。根据记录进行临床和放射学评价。在关节镜下评估盘状半月板的类型和撕裂的类型。所有患者均接受了关节镜下半月板切除术。对患者进行至少2年的随访。所有患者均以疼痛为主要症状。8名患者出现双侧膝关节疼痛，4名患者在患侧膝关节接受治疗后出现对侧膝关节疼痛。经典描述的撞击声出现在11个膝盖上。膝关节X线片显示关节间隙增宽13例，完全型14膝，不完全型9膝，环型1例，盘状外侧半月板10个完全型20膝，均为不完全型和环型，均有明显的半月板撕裂。其余四个半月板显示部分半月板软化。在关节镜下，在茶托切开时软化的区域可以看到潜在的物质内撕裂。除1例盘状半月板外，其余均行关节镜下中央半月板部分切除术。平均随访32.6个月，优19膝，良5膝。盘状外侧半月板可能存在双侧畸形。半月板软化表明潜在的实质内撕裂。到目前为止，这一发现还没有在文献中被描述。关节镜下半月板部分切除术治疗有症状的双侧盘状半月板效果良好。据我们所知，这是最大的双侧盘状外侧半月板系列。
The purpose of the study is to evaluate clinical, radiologic and arthroscopic features of bilateral discoid lateral meniscus and to assess the outcome of arthroscopic meniscectomy. Among the 177 arthroscopies performed for discoid lateral meniscus between January 1993 and January 2004, 12 were bilateral. The clinical and radiologic evaluation was done from the records. The type of discoid meniscus, the type of tear was assessed arthroscopically. All patients underwent arthroscopic meniscectomy. Patients were followed up for a minimum period of 2 years. All patients had pain as presenting symptom. Eight patients presented with bilateral knee pain and four patients developed pain in the opposite knee after the affected knee was treated. The classically described thud was present in 11 knees. The widening of the joint space was found in 13 knee radiographs; 14 knees had complete type, nine had incomplete type and one had ring type of discoid lateral meniscus on arthroscopic evaluation; 20 knees involving 10 complete types, all incomplete types and ring type of discoid lateral meniscus showed obvious meniscal tears. The remaining four meniscus showed softening of a portion of the meniscus. Underlying intra-substance tear was visualized arthroscopically in the softened areas on saucerisation. All but one discoid menisci underwent arthroscopic partial central meniscectomy. When followed up for an average period of 32.6 months 19 knees showed excellent results and 5 knees good results. Possibility of bilaterality should be suspected in discoid lateral meniscus. Softening of meniscus denotes underlying intra-substance tear. This finding has not been described in the literature so far. Arthroscopic partial meniscectomy gives good results in symptomatic bilateral discoid meniscus. This to our knowledge is the largest series of bilateral discoid lateral menisci.