Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep 24;6(9):2325967118797886.
doi: 10.1177/2325967118797886. eCollection 2018 Sep.

Incidence and Treatment Trends of Symptomatic Discoid Lateral Menisci: An 18-Year Population-Based Study

Orlando D Sabbag  1 , Mario Hevesi  1 , Thomas L Sanders  1 , Christopher L Camp  1 , Diane L Dahm  1 , Bruce A Levy  1 , Michael J Stuart  1 , Aaron J Krych  1
Affiliations

Incidence and Treatment Trends of Symptomatic Discoid Lateral Menisci: An 18-Year Population-Based Study

Orlando D Sabbag et al. Orthop J Sports Med. .

Abstract

Background: A symptomatic discoid lateral meniscus is an uncommon orthopaedic abnormality, and the majority of information in the literature is limited to small case series.

Purpose/hypothesis: The purpose of this study was to determine the incidence of symptomatic discoid menisci in a geographically determined population and to describe treatment trends over time. The hypothesis was that the incidence of symptomatic discoid menisci would be highest among adolescent patients, and thus, the rate of surgical treatment would be high compared with nonoperative treatment.

Study design: Descriptive epidemiology study.

Methods: The study population included 79 patients in Olmsted County, Minnesota, identified through a geographic database, who were diagnosed with a symptomatic discoid lateral meniscus between 1998 and 2015. The complete medical records were reviewed to confirm the diagnosis and evaluate the details of injury and treatment. Age- and sex-specific incidence rates were calculated and adjusted to the 2010 United States population.

Results: The overall annual incidence of symptomatic discoid lateral menisci was 3.2 (95% CI, 2.5-3.9) per 100,000 person-years; 12.6% of the patients in the cohort had bilateral symptomatic discoid lateral menisci. The overall annual incidence was similar between male (3.5 per 100,000 person-years) and female patients (2.8 per 100,000 person-years). The highest incidence of symptomatic discoid lateral menisci was noted in adolescent male patients aged 15-18 years (18.8 per 100,000 person-years). A majority (72.2%) of patients presented with a symptomatic tear of the discoid meniscus. The remaining patients presented with mechanical symptoms, including catching/locking or effusion, with no demonstrable meniscus tear on imaging or diagnostic arthroscopic surgery. Additionally, 20.0% of patients were observed to have peripheral instability of the meniscus at the time of diagnostic arthroscopic surgery. The mean age of those with peripheral instability was significantly younger than of those who did not have peripheral instability. Sixty patients (75.9%) received surgical treatment during the study period, including 49 (81.7%) patients who underwent partial lateral meniscectomy and 11 (18.3%) patients who underwent lateral meniscus repair in addition to saucerization.

Conclusion: With an overall annual incidence of 3.2 per 100,000 person-years, a symptomatic discoid meniscus is an uncommonly encountered orthopaedic abnormality. However, the incidence of symptomatic discoid lateral menisci is highest in adolescent male patients. Because of the high rate of meniscus tears in patients presenting with symptoms, the majority are treated surgically.

Keywords: discoid meniscus; incidence; meniscus tear; surgical treatment.

PubMed Disclaimer

Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: C.L.C. has received educational support from Stryker, Zimmer Biomet, and Arthrex. D.L.D. receives research support from Arthrex, and her spouse has stock/stock options in and receives royalties from Tenex Health and Sonex Health. B.A.L. receives royalties from Arthrex; is a paid consultant for Arthrex, ConMed Linvatec, and Smith & Nephew; and receives research support from Arthrex, Biomet, and Stryker. M.J.S. is a consultant for Arthrex, receives royalties from Arthrex, and receives research support from Stryker. A.J.K. receives research support from Aesculap/B. Braun, Arthrex, the Arthritis Foundation, Ceterix Orthopaedics, Histogenics, the Musculoskeletal Transplant Foundation, and DePuy Orthopaedics; receives royalties from Arthrex; and is a consultant for Arthrex, JRF Ortho, and Vericel. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
(A) Coronal and (B) sagittal magnetic resonance imaging views of a complete discoid lateral meniscus. The ratio of the minimal meniscal width to the maximal tibial width in the coronal plane is greater than 20%. The sagittal view shows the classic “bow tie” sign.
Figure 2.
Figure 2.
Arthroscopic view of a discoid lateral meniscus. (A) A discoid lateral meniscus with near complete coverage of the tibial plateau. (B) An unstable discoid lateral meniscus.
Figure 3.
Figure 3.
Distribution of patients in the surgical group according to the type of procedure.
See this image and copyright information in PMC

References

    1. Atay OA, Pekmezci M, Doral MN, Sargon MF, Ayvaz M, Johnson DL. Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med. 2007;35(3):475–478. - PubMed
    1. Bae JH, Lim HC, Hwang DH, Song JK, Byun JS, Nha KW. Incidence of bilateral discoid lateral meniscus in an Asian population: an arthroscopic assessment of contralateral knees. Arthroscopy. 2012;28(7):936–941. - PubMed
    1. Bellier G, Dupont JY, Larrain M, Caudron C, Carlioz H. Lateral discoid menisci in children. Arthroscopy. 1989;5(1):52–56. - PubMed
    1. Casscells SW. Gross pathological changes in the knee joint of the aged individual: a study of 300 cases. Clin Orthop Relat Res. 1978;(132):225–232. - PubMed
    1. Dashefsky JH. Discoid lateral meniscus in three members of a family: case reports. J Bone Joint Surg Am. 1971;53(6):1208–1210. - PubMed

LinkOut - more resources