Symptomatic discoid lateral meniscus: A clinical and arthroscopic study in a Chinese population

Abstract

Background: Discoid lateral meniscus (DLM) is relatively common in East Asia.Symptomatic discoid lateral meniscus (SDLM) is an important indication for knee arthroscopic surgery. However, studies investigating SDLM are rare. The purpose of this study was to evaluate the clinical characteristics and intra-articular variants of SDLM in a Chinese population. Methods: We retrospectively reviewed all patients with SDLM from January 2005 to December 2014 in our hospital. Clinical variables included gender, age, duration, age of onset, affected side, symptoms and trauma history as well as arthroscopic findings: DLM types, tear patterns and concomitant medial meniscus tear, which were evaluated and compared statistically. Results: Of the 496 consecutive participants with SDLM, females outnumbered males (69.6 % vs. 30.4 %). The age of onset ranged from 3 to 80 years (median, 31 years), and was significantly higher in females than in males (p < 0.0001). Trauma history in males was significantly higher than in females (45 % vs. 35.1 %, p = 0.0356). Males showed a higher incidence of popping and snapping, while females manifested higher range-of-motion (ROM) limitations (p = 0.0179, and p = 0.0392, respectively). No significant difference in intra-articular variants was observed between genders. The complete type was the most frequent (344, 69.4 %), followed by the incomplete type (149, 30 %), and the Wrisberg type (3, 0.6 %). Significant difference in tear patterns was found between complete and incomplete types (p < 0.0001). Few patients showed medial meniscus tear (11, 2.2 %), at a significantly higher age compared with patients without tear (median, 57 years vs. 33 years, p < 0.0001). Conclusions: The majority of Chinese patients with SDLM are young and middle-aged females. Female patients had an older age of onset, higher incidence of ROM limitation and limited trauma history. The complete type is the most common, with tear patterns varying between complete and incomplete types. The SDLM does not significantly affect the medial meniscus.