Comparative analysis of discoid lateral meniscus size: a distinction between symptomatic and asymptomatic cases

Knee Surg Sports Traumatol Arthrosc. 2023 Dec;31(12):5783-5790. doi: 10.1007/s00167-023-07650-2. Epub 2023 Nov 7.

Abstract

Purpose: This study evaluated the differences in meniscal sizes and occupancy between symptomatic and asymptomatic patients diagnosed with discoid lateral meniscus (DLM) using magnetic resonance imaging (MRI) to understand how these variations relate to the presence of symptoms and the patients' age.

Methods: A retrospective review of 98 patients with DLM was conducted, excluding those with meniscal displacement. Both the width and extrusion of DLM and the percentage of the meniscus to the tibia were measured using mid-coronal and mid-sagittal MRI and compared between symptomatic and asymptomatic DLM groups. The relationships among each parameter, meniscal size, and patient age were evaluated. Symptomatic cases were divided into those with and without horizontal tears on MRI to compare the differences in meniscal morphology.

Results: A total of 92 knees from 74 patients were included. Sixty-one knees required surgical intervention for symptomatic DLM, while 31 were asymptomatic and included the contralateral side of symptomatic knees. The symptomatic group exhibited larger morphological variations than the asymptomatic group. Moreover, the sagittal meniscal ratio reduced with age in the asymptomatic group (r = - 0.54, p = 0.002) but remained constant in the symptomatic group. The symptomatic cases with horizontal tears demonstrated larger meniscal dimensions and smaller posterior capsule distances than those without tears.

Conclusion: Symptomatic patients with DLM had larger knee morphological changes than asymptomatic ones. Age affected the meniscal occupancy in the sagittal plane only in asymptomatic patients.

Level of evidence: III.

Keywords: DLM; Discoid lateral meniscus; Knee joint; Magnetic resonance image.

MeSH terms

  • Arthroscopy
  • Humans
  • Knee
  • Knee Joint / diagnostic imaging
  • Magnetic Resonance Imaging*
  • Menisci, Tibial* / surgery
  • Retrospective Studies
  • Rupture / pathology
  • Tibia