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Discoid Lateral Meniscus: Prevalence of Peripheral Rim Instability

Klingele, Kevin E. MD*; Kocher, Mininder S. MD, MPH; Hresko, M. Timothy MD; Gerbino, Peter MD; Micheli, Lyle J. MD

Knee/Tibia
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The purpose of this study was to determine the prevalence of peripheral rim instability in discoid lateral meniscus. A consecutive series of 112 patients (128 knees) (mean age 10.0 years [range 1 month to 22 years]) who underwent arthroscopic evaluation and treatment of a discoid lateral meniscus between 1993 and 2001 was reviewed. Of those discoid menisci classified intraoperatively (n = 87), 62.1% (n = 54) were complete discoid lateral menisci and 37.9% (n = 33) were incomplete discoid lateral menisci. An associated meniscal tear was present in 69.5% (n = 89) of all knees studied. Overall, 28.1% (n = 36) of discoid lateral menisci had peripheral rim instability: 47.2% (n = 17) were unstable at the anterior-third peripheral attachment, 11.1% (n = 4) at the middle-third peripheral attachment, and 38.9% (n = 14) at the posterior-third peripheral attachment. Thirty-one of the 36 unstable discoid menisci underwent repair of the peripheral meniscal rim attachment. One patient underwent a complete, open meniscectomy. Peripheral rim instability was significantly more common in complete discoid lateral menisci (38.9% vs. 18.2%; P = 0.043) and in younger patients (8.2 vs. 10.7 years; P = 0.002). The frequency of peripheral instability mandates a thorough assessment of meniscal stability at all peripheral attachments during the arthroscopic evaluation and treatment of discoid lateral meniscus, particularly in complete variants and in younger children.

Study conducted at Children's Hospital, Boston, Massachusetts.

From the *Department of Orthopaedic Surgery, Columbus Children's Hospital, Greater Ohio Orthopaedic Surgeons, Inc., Columbus, Ohio; †Department of Orthopaedic Surgery, Children's Hospital, Boston, Massachusetts.

None of the authors received financial support for this study.

Reprints: Kevin E. Klingele, MD, Department of Orthopaedic Surgery, Columbus Children's Hospital, Greater Ohio Orthopaedic Surgeons, Inc., 259 Taylor Station Road, Columbus, OH 43213 (e-mail: kklingele@goosi.com).

© 2004 Lippincott Williams & Wilkins, Inc.