Symptomatic lateral discoid meniscus in children. A systematic literature review and retrospective study of 32 cases

A disk-shaped meniscus is a commonly known alternative to the C-shaped meniscus, which is defined by a larger-than-normal meniscus body. However, the enlarged meniscus has a severe disadvantage, which is the increase in shearing forces exerted on it, which can lead to a tear in its body. The Wrisberg form of discoid lateral meniscus is a rare abnormality. The absence of the posterior meniscotibial ligament results in an excessive range of movement and instability of the meniscus, with only its meniscofemoral ligament (Wrisberg’s ligament) remaining intact and attached to the posterior horn of the meniscus. Additionally, a Wrisberg variant can exhibit a significant disorder in its microstructure due to an abnormal collagen network, mucosal disintegration, and a lack of vascularity. This study includes 32 skeletally immature patients who came to our institution with symptomatic discoid lateral meniscus. The initial evaluation of every knee included magnetic resonance imaging (MRI), followed by arthroscopy. MRI enables the classification of discoid meniscus based on meniscal morphology, stability or instability, meniscal intrasubstance degradation, and the occurrence of meniscal rupture. The discoid meniscus was reshaped, excising the hypertrophied central portion of the meniscus. The International Knee Documentation Committee (IKDC) system, which is an online system for the evaluation of knee function, was utilized. Twenty-four discoid menisci were assessed as being stable and having a tear in their body. Eight discoid menisci were determined to be unstable (Wrisberg variant) with degeneration within their substance but no meniscus tear. At surgery, the mean age of the patients was 11.81+/−2.62 years (range 5–14 years). The average follow-up was 3.71+/−0.92 years (range, 3–6). The mean preoperative IKDC score was 44.71+/−14.42 (range, 21–57) points. Postoperatively, the mean IKDC score was 81.56+/−1.70 (range, 79–84) points. The two-tailed [Formula: see text]-value was < 0.0001. The assumption that MRI assessment is essential not only for detecting the Wrisberg alternate but also for uncovering possible meniscal disintegration and intra-substance alterations that are not usually observed through arthroscopy is supported by our data.