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. 2018:53:372-376.
doi: 10.1016/j.ijscr.2018.11.027. Epub 2018 Nov 22.

Arthroscopic minimum saucerization and inferior-leaf meniscectomy for a horizontal tear of a complete discoid lateral meniscus: Report of two cases

Akira Tsujii  1 , Tomohiko Matsuo  2 , Kazutaka Kinugasa  3 , Yasukazu Yonetani  4 , Masayuki Hamada  5
Affiliations

Arthroscopic minimum saucerization and inferior-leaf meniscectomy for a horizontal tear of a complete discoid lateral meniscus: Report of two cases

Akira Tsujii et al. Int J Surg Case Rep. 2018.

Abstract

Introduction: Treatment of a horizontal tear of a complete discoid lateral meniscus (DLM) is still controversial. Preserving peripheral rim as a normal shape of the meniscus with single-leaf resection is a conventional treatment, however meniscal function could not be fully restored.

Presentation of case: A 28-year old woman and a 34-year old woman experienced knee pain and had restricted knee extension. MRI showed horizontal tears of complete DLM in both patients. Arthroscopic minimum saucerization preserving more than 10 mm peripheral rim and inferior-leaf meniscectomy was performed. Two years after the surgery, the patient had no pain and no restriction of ROM. MRI showed the remaining superior-leaf maintained about half its width and no progression of coronal/sagittal extrusion.

Discussion and conclusion: As resecting more meniscal tissue has been considered to be a cause of degeneration or extrusion of the meniscus, arthroscopic minimum saucerization, preserving more meniscal tissue than standard saucerization, and inferior-leaf meniscectomy can be an alternative treatment option of horizontal tears of complete DLM with satisfying clinical and radiological results.

Keywords: Discoid lateral meniscus; Horizontal tear; Inferior-leaf meniscectomy; Saucerization.

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Figures

Fig. 1
Fig. 1
Preoperative images of the first case. Rosenberg-view radiograph of bilateral knees (a). T2-weighted MRI shows a discoid lateral meniscus with a horizontal high signal cleavage (arrow) throughout its body in mid-coronal (b) and mid-sagittal (c) sections.
Fig. 2
Fig. 2
Intraoperative arthroscopic images of the first case. No tear on the femoral side of the discoid lateral meniscus (a). Resection of the central portion (b). Horizontal tear throughout its body (c). Resection of the inferior leaf with a forceps (d). Resection of the anterior part of the inferior leaf with a shaver via an inferomeniscal portal (e). About half of the width of the remaining stable leaf is preserved (f).
Fig. 3
Fig. 3
Postoperative images of the first case at 2 years after the surgery. Rosenberg-view (a). Mid-coronal (b) and mid-sagittal (c) T2-weighted MRI images.
Fig. 4
Fig. 4
Images of the second case. Preoperative Rosenberg-view radiograph of bilateral knees (a). Intraoperative arthroscopic images; no tear on the femoral side of the discoid lateral meniscus (b), horizontal tear throughout its body (c), and about half of the width of the remaining stable leaf is preserved (d). Postoperative Rosenberg-view (e) at 2 years after surgery.
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