BACKGROUND: To assess the viability and efficiency of performing arthroscopic meniscoplasty in treating discoid meniscus (DM) in the knee joint.
METHODS: A total of 29 patients diagnosed with symptomatic lateral DM between October 2014 and December 2019 were included in the study. Among them, 7 patients with intact DM underwent arthroscopic discoid meniscoplasty (group A), while 22 patients with torn DM received arthroscopic DM plasty along with repair and suturing (group B). Both Visual Analog Scale (VAS) score and Lysholm score assessments were conducted preoperatively and postoperatively.
RESULTS: The favorable and acceptable outcome rate was 85.71% in group A and 95.45% in group B (P > 0.05). The VAS scores post-operatively at each follow-up time point were consistently lower compared to pre-operative values, while the Lysholm knee function scores showed improvement. There were no significant differences in VAS score and Lysholm score between group A and group B at different stages (P > 0.05). Both surgical techniques (discoid meniscoplasty and discoid meniscoplasty combined with repair and suture) showed significant improvement in postoperative VAS score and Lysholm score, but there was no difference in outcomes between the two groups.
CONCLUSIONS: Overall, the two surgical techniques studied in this study (discoid meniscoplasty and discoid meniscoplasty combined with repair and suture) produced similar results in terms of pain reduction and improved knee function.

A discoid meniscus is a morphological abnormality wherein the meniscus loses its normal \'C\' shape. Although most patients are asymptomatic, patients might still present with symptoms such as locking, pain, swelling, or giving way. Magnetic resonance imaging is usually needed for confirmation of diagnosis. Based on a constellation of factors, including clinical and radiological, different approaches are chosen for the management of discoid meniscus. The purpose of this review is to outline the treatment of discoid meniscus, starting from conservative approach, to the different surgical options for this condition. The PubMed and Google Scholar databases were used for this review. Studies discussing the treatment of discoid meniscus from 2018 to 2023 were searched. Initially there were 369 studies retrieved, and after removal of studies using the exclusion criteria, 26 studies were included in this review. Factors such as stability, presence of tear, and morphology can help with surgical planning. Many approaches have been used to treat discoid meniscus, where the choice is tailored for each patient individually. Postoperatively, factors that may positively impact patient outcomes include male sex, body mass index < 18.5, age at symptom onset < 25 years, and duration of symptoms < 24 months. The conventional approach is partial meniscectomy with or without repair; however, recently, there has been an increased emphasis on discoid-preserving techniques such as meniscoplasty, meniscopexy, and meniscal allograft transplantation.

UNASSIGNED: This study aimed to reach a consensus for ideal surgical treatment of discoid lateral meniscus (DLM) and to evaluate its long term surgical and radiological outcome.
UNASSIGNED: All authors independently searched for peer reviewed publications with keywords like discoid lateral meniscus, tibial menisci abnormalities, tibial menisci surgery and clinical outcome and their representative Medical Subjects Headings (MeSH) in databases of PubMed, EBSCO, Cochrane Central Register of Controlled Trials, from inception to December 2022. Original articles in English language on discoid lateral meniscus reporting clinical, surgical, or radiological outcomes with five or more years of follow-up were included in this systematic review. Study details and outcome data were analysed according to the age, follow-up period, kind of surgery, DLM type, and alignment.
UNASSIGNED: Our search strategy yielded 654 articles in PubMed, 222 articles in EBSCO and 5 articles in CENTRAL i.e. a total of 881 articles. After detailed assessment and screening, 12 articles were included in the final analysis, which included 444 DLM cases. The mean patient age at surgery ranged from 9.9 to 35.9 years, and the mean follow-up period ranged from 5.2 to 16 years. Partial meniscectomy and meniscoplasty are the recommended treatment because of the concerns of degenerative arthritis development after the total and subtotal meniscectomies. Two studies have documented better results with meniscal allograft transplantation.
UNASSIGNED: Satisfactory clinico-radiological outcome can be obtained after surgical treatment of discoid lateral meniscus with meniscus reshaping and repair of peripheral unstable part. Meniscal allograft transplantation (MAT) is gaining popularity in patients with total meniscectomy with satisfactory long term functional outcome.

UNASSIGNED: To discuss the application of anterior region suture of the popliteal hiatus (PH) under arthroscopy in the treatment of discoid lateral meniscus (DLM) injury with instability in the popliteal tendon region.
UNASSIGNED: The clinical data of 53 patients (56 knees) with DLM injury who met the selection criteria between March 2014 and November 2022 were retrospectively analyzed. There were 15 males and 38 females, aged 8-55 years with an average age of 36.5 years. Fourteen cases had a history of trauma, while the remaining 39 cases had no clear history of trauma. The disease duration ranged from 1 day to 6 years, with an average duration of 15.6 months. According to the Watanabe classification, there were 40 knees of complete type and 16 knees of incomplete type. The preoperative International Knee Documentation Committee (IKDC) knee joint score was 51.2±8.3, the Lysholm score was 59.6±11.2, and the visual analogue scale (VAS) score was 4.7±1.3. After the arthroscopic meniscal plasty, the instability of the popliteal tendon region meniscus was checked by probing traction. Subsequently, the Out-inside technique or a combination of Out-inside and All-inside techniques was used to suture the anterior region of the PH. The stability of the meniscus after suturing was assessed, and if necessary, further suturing using the All-inside technique at the posterior region of the PH, the posterior horn of the meniscus, and using the Out-inside technique at the anterior horn of the meniscus was performed. Postoperative complications were recorded. The effectiveness was evaluated using pre- and post-operative IKDC scores, Lysholm scores, and VAS scores.
UNASSIGNED: After operation, knee joint pain, crepitus, and locking disappeared, with McMurray and grinding tests turning negative. All patients were followed up 12-93 months with an average of 57.5 months. There was no complication such as common peroneal nerve injury, deep vein thrombosis of the lower limbs, joint infection, or joint stiffness. At last follow-up, the IKDC knee joint score was 76.7±5.5, the Lysholm score was 94.0±4.1, and the VAS score was 1.1±0.8. The differences compared with preoperative scores were significant ( t=-22.090, P<0.001; t=-23.704, P<0.001; t=19.767, P<0.001).
UNASSIGNED: Suturing of the anterior region of the PH is crucial in the treatment of DLM injury with instability in the popliteal tendon region.
UNASSIGNED: 探讨关节镜下腘肌腱裂孔（popliteal hiatus，PH）前区缝合在外侧盘状半月板（discoid lateral meniscus，DLM）损伤并腘肌腱区不稳治疗中的应用。.
UNASSIGNED: 回顾分析2014年3月—2022年11月收治且符合选择标准的53例（56膝）DLM损伤患者临床资料。男15例，女38例；年龄8～55岁，平均36.5岁。14例有外伤史，余39例无明确外伤史。病程1 d～6年，平均15.6个月。根据Watanabe分型：完全型40膝，不完全型16膝。术前国际膝关节文献委员会（IKDC）膝关节评分为（51.2±8.3）分，Lysholm评分为（59.6±11.2）分，疼痛视觉模拟评分（VAS）为（4.7±1.3）分。行关节镜下半月板成形术后，用探钩牵拉检查腘肌腱区半月板均存在不稳，进而采用Out-inside技术或Out-inside技术联合All-inside技术缝合PH前区，检查缝合后半月板稳定性，必要时再采用All-inside技术缝合PH后区、半月板后角和Out-inside技术缝合半月板前角。记录并发症发生情况；采用手术前后IKDC评分、Lysholm评分和VAS评分评价疗效。.
UNASSIGNED: 术后膝关节疼痛、关节弹响及交锁症状消失，McMurray试验及研磨试验转为阴性。53例患者均获随访，随访时间12～93个月，平均57.5个月。无腓总神经损伤、下肢深静脉血栓形成、关节感染和关节僵硬等并发症发生。末次随访时IKDC膝关节评分为（76.7±5.5）分，Lysholm评分为（94.0±4.1）分，VAS评分为（1.1±0.8）分，与术前比较差异均有统计学意义（ t=−22.090， P<0.001； t=−23.704， P<0.001； t=19.767， P<0.001）。.
UNASSIGNED: PH前区缝合是DLM损伤并腘肌腱区不稳治疗的关键。.

UNASSIGNED: To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment.
UNASSIGNED: The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases. There were 49 cases of left knee injury and 42 cases of right knee injury. The time from the onset of symptoms to the admission ranged from 1 day to 13 months (median, 18 days), including >1 month in 35 cases and ≤1 month in 56 cases. Medial BHMTs occurred in 52 cases and lateral BHMTs in 39 cases. There were 36 cases with ACL rupture and 12 cases with discoid meniscus. The knee extension was limited more than 10° in 55 cases. According to the condition of meniscus injury, the meniscus suture with Inside-out combined with All-inside techniques (54 cases) or meniscoplasty (37 cases) under arthroscopy were selected. ACL reconstruction was performed in all patients with ACL rupture with autogenous hamstring tendon. Postoperative complications were observed. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were used to evaluate knee function, and clinical failure was recorded.
UNASSIGNED: Two patients developed intermuscular venous thrombosis, which improved after oral anticoagulant therapy. No vascular injury, postoperative infection, joint stiffness, or other complications occurred in all patients. All patients were followed up 24-95 months, with a median of 64 months. A total of 12 cases (13.19%) failed the operation and were re-operated or given oral anti-inflammatory analgesics and rehabilitation therapy. At last follow-up, IKDC score and Lysholm score of 91 patients significantly increased when compared with those before operation ( P<0.05), while Tegner score significantly decreased ( P<0.05). The above indexes of patients treated with meniscus suture and meniscoplasty were also significantly different from those before operation ( P<0.05).
UNASSIGNED: BHMTs occurs mostly in young men and is one of the important reasons for the limitation of knee extension after trauma. Arthroscopic meniscus suture and meniscoplasty can obtain good effectiveness according to individual conditions of patients. But the latter can better preserve the shape and function of meniscus, and theoretically can obtain better long-term outcomes, which needs to be confirmed by further research with larger sample size.
UNASSIGNED: 总结半月板桶柄样撕裂（bucket-handle meniscal tears，BHMTs）患者临床特征以及手术方式选择、预后，为临床治疗提供参考。.
UNASSIGNED: 回顾分析2015年1月—2021年1月收治且符合选择标准的91例BHMTs患者（91膝）临床资料。男68例，女23例；年龄16～58岁，平均34.4岁。致伤原因： 运动损伤68例，交通事故伤15例，摔伤或扭伤8例。损伤侧别：左膝49例，右膝42例。患者出现症状至就诊时间为1 d～13个月，中位时间18 d；其中>1个月35例、≤1个月56例。BHMTs发生于内侧52例、外侧39例。55例膝关节伸直受限>10°。合并ACL断裂36例，盘状半月板12例。根据半月板损伤情况，选择于关节镜下Inside-out技术联合All-inside技术半月板缝合术（54例）或半月板成形术（37例），合并ACL断裂者均行自体腘绳肌腱重建。术后观察并发症发生情况，采用国际膝关节文献委员会（IKDC）评分、Lysholm评分、Tegner评分评价膝关节功能，记录手术临床失败发生情况。.
UNASSIGNED: 术后2例半月板缝合术患者出现下肢肌间静脉血栓形成，给予口服抗凝治疗后好转。所有患者无血管损伤、感染、关节僵硬等并发症发生。患者均获随访，随访时间24～95个月，中位时间64个月。随访期间12例（13.19%）手术临床失败，给予再次手术或对症保守治疗。末次随访时，91例患者IKDC评分、Lysholm评分均较术前提高，Tegner评分较术前下降，差异均有统计学意义（ P<0.05）；半月板缝合术及成形术患者上述指标与术前差异亦有统计学意义（ P<0.05）。.
UNASSIGNED: BHMTs是外伤后膝关节伸直受限的重要原因之一，多发生于青年男性。根据患者个体情况选择关节镜下半月板成形术或缝合术，均可获得较好疗效。但后者可以更好地保留半月板形态和功能，理论上可获得更好远期疗效，但有待进一步扩大样本量、延长随访时间比较明确。.

A high prevalence of osteoarthritis (OA) progression in patients with lateral meniscal defects has been reported. However, optimal management techniques for active patients remain ill-defined.
Meniscoplasty by capsular advancement with the application of the centralization technique would improve clinical and radiological outcomes in patients with lateral compartment OA attributed to lateral meniscal defects.
Case series; Level of evidence, 4.
A total of 27 patients were enrolled who had undergone meniscoplasty by capsular advancement for lateral compartment OA attributed to lateral meniscal defects. In these patients, the meniscotibial capsule was released from the tibia and advanced with the remaining meniscus onto the rim of the tibial plateau to reform a meniscus-like configuration. Measures of clinical outcomes included clinical examination, Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Knee injury and Osteoarthritis Outcome Score (KOOS), subjective rating scales regarding recovery of the operated knee, and sports performance level. Measures of radiographic outcomes included meniscal extrusion width or regeneration of the meniscus-like tissue on magnetic resonance imaging and lateral joint space width on standing extension anteroposterior and Rosenberg views. All clinical and radiographic outcomes were reported preoperatively and 2 years postoperatively, except magnetic resonance imaging findings, which were reported preoperatively and 1 year postoperatively.
The clinical outcomes were significantly improved 2 years postoperatively as compared with baseline: Lysholm score, IKDC subjective score, and KOOS subscores (all P < .0001). The patients\' subjective recovery (P < .0001) and sports performance level (P < .0001) were also improved. One year postoperatively, 10 of 11 patients who had no meniscus remaining at the middle segment showed more than one-third the volume of meniscal tissue-like regeneration, and meniscal extrusion width was significantly reduced as compared with baseline in the remaining 16 patients (P = .0006). Joint space width increased at 2 years on the standing anteroposterior view (P < .0001) and the Rosenberg view (P = .0001).
Meniscoplasty of the lateral meniscus by capsular advancement improved clinical and radiographic outcomes at 2-year follow-up in patients with lateral compartment OA attributed to lateral meniscal defects.

OBJECTIVE: To date, there have been limited studies reporting the mid- to long-term outcomes of meniscoplasties for discoid lateral meniscus. The current study aims to evaluate the mid- to long-term outcomes of arthroscopic meniscoplasty for discoid lateral meniscus in children and adolescents.
METHODS: In the study, all patients under the age of 21 years who had undergone arthroscopic meniscoplasty with or without meniscal repair or partial meniscectomy for symptomatic lateral discoid meniscus were included. All patients were then followed up for a minimum of 5 years (median 84 months; range 68-110 months). The Lysholm scores and Ikeuchi scores were collected pre-operatively and at final follow-up and were compared.
RESULTS: A total of 24 knees were included in the study. The median duration of follow-up was 84.0 months (range 68-110 months). The Lysholm score improved from 53 (range 11-95) pre-operatively to 100.0 (range 60-100) at final follow-up (p < 0.001). Based on the Ikeuchi score pre-operatively, 15 knees were rated as poor (62.5%), 7 knees were rated as fair (29.2%), and 2 knees were rated as good (8.4%). The Ikeuchi score improved significantly at the final follow-up, such that 1 knee was rated as good (4.2%) and 23 knees were rated as excellent (95.8%) (p < 0.001). When analysing the effect of concomitant meniscal repair or partial meniscectomy on the outcomes at final follow-up, there was no apparent difference in the improvement in Lysholm score or Ikeuchi score when comparing between patients who had meniscoplasty alone and patients who had concomitant meniscal repair, as well as when comparing between patients who had meniscoplasty alone and patients who had concomitant partial meniscectomy.
CONCLUSIONS: Meniscoplasty leads to good mid-term to long-term outcomes for children and adolescents with discoid lateral meniscus. Concomitant procedures such as meniscal repair or partial meniscectomy do not improve or worsen the mid- to long-term outcomes in these patients.
METHODS: IV.

BACKGROUND: Normal menisci of the knee are semilunar structures. Sometimes, a meniscus may be found to be thickened and disc like and is called a discoid meniscus. Such a discoid variant is usually found in the lateral meniscus. Its occurrence in the medial meniscus is extremely rare.
METHODS: We report a case of an 18-year-old female, who presented to us with knee pain and was found to have a discoid medial meniscus with a tear. We operated on her arthroscopically and performed meniscectomy and meniscoplasty. Postoperatively, the patient was free of her knee pain.
CONCLUSIONS: Discoid medial meniscus is a rare phenomenon which can present as a cause of knee pain. If discoid meniscus is symptomatic, the management includes arthroscopic meniscectomy and meniscoplasty.

BACKGROUND: Discoid lateral meniscus lesions are relatively rare. The objective of this study was to determine the long-term results of 14 cases of discoid lateral meniscus tears treated by arthroscopic meniscoplasty between July 1991 and May 2009, and to assess the development of osteoarthritis in the lateral compartment.
METHODS: The series consisted of 10 patients (14 knees): 3 girls under the age of 15, 3 men and 4 women aged from 16 to 47 years (mean age: 31.4±11.1 years). The main reason for consultation was pain in 10 cases, locking in 2 cases and pain associated with locking in 2 cases. The diagnosis was confirmed preoperatively by MRI in 10 cases, CT-arthrography in 1 case and arthrography in 3 cases. The indication for surgery was made because of a symptomatic discoid lateral meniscus. All cases were treated by arthroscopic meniscal reshaping. Functional results were evaluated using the Lysholm-Tegner, IKDC, KOOS and satisfaction scores. Radiological results were evaluated based on the modified Alhbäck classification for osteoarthritic (OA) changes.
RESULTS: No complications were found. Two patients were lost to follow-up. The remaining eight patients (12 knees) were reviewed at a mean of 157.5±72.1 months (61-276). The mean Lysholm-Tegner score was 88.9±10.6 points (67-100), the mean KOOS was 92.4±9.5 (65-100) and the mean IKDC score was 85.4±16.5 points (65-100). All eight of the reviewed patients were satisfied or very satisfied with the result. Radiological analysis found that five knees had no signs of OA, five knees had stage 1, one had stage 2 and one had stage 3. At last follow-up, no patient had been reoperated.
CONCLUSIONS: Meniscoplasty of discoid lateral meniscus tears leads to excellent long-term functional results despite signs of osteoarthritic changes in the lateral compartment of the knee.
METHODS: IV (retrospective study).