Surgical Repair of Symptomatic Wrisberg Variant Discoid Lateral Mensicus with Pull-Out Repair and Capsulodesis

Nobutake Ozeki; Hideyuki Koga; Tomomasa Nakamura; Yusuke Nakagawa; Toshiyuki Ohara; Yuji Kohno; Ichiro Sekiya

doi:10.1016/j.eats.2021.09.003

Surgical Repair of Symptomatic Wrisberg Variant Discoid Lateral Mensicus with Pull-Out Repair and Capsulodesis

Arthrosc Tech. 2021 Dec 22;11(1):e61-e68. doi: 10.1016/j.eats.2021.09.003. eCollection 2022 Jan.

Authors

Nobutake Ozeki¹, Hideyuki Koga², Tomomasa Nakamura², Yusuke Nakagawa², Toshiyuki Ohara³, Yuji Kohno¹, Ichiro Sekiya¹

Affiliations

¹ Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
² Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
³ Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University Hospital of Medicine, Yushima, Bunkyo-ku, Tokyo, Japan.

Abstract

Wrisberg variant discoid lateral meniscus (DLM) is a congenital anatomic variation of the meniscus in the knee joint, which is an uncommon type of the DLM. We present a surgical technique in a case of symptomatic Wrisberg variant DLM. To improve the instability due to the lack of the posterior attachment of meniscotibial ligament, the posterior portion of DLM was attached to the insertion site of normal LM posterior root using pull-out repair technique. In addition, a longitudinal tear from the anterior to the middle portion of DLM was repaired with outside-in and inside-out techniques. Finally, a capsulodesis using knotless anchors was performed from outside of the joint to prevent the meniscus extrusion after the surgery. Knee symptoms such as pain, catching, and ROM restriction disappeared at 3 months after the surgery. Postoperative magnetic resonance imaging showed a slightly sharpened shape of the DLM, and the attachment of the posterior portion of the DLM was observed. Longitudinal tear of the DLM was healed without cleavage. This procedure is useful to improve the symptoms of the knee joint with Wrisberg variant DLM and to preserve the function of the meniscus.