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Discoid Meniscus and Meniscoplasty in Children

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Surgery of the Meniscus

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Abstract

The identification of symptomatic discoid lateral meniscus (DLM) in children requires an appropriate level of clinical suspicion based upon the patient’s medical history and symptoms and the judicious use of imaging studies (including plain films and magnetic resonance imaging (MRI) and diagnostic arthroscopy). It is the authors’ experience that a high frequency of bilaterality occurs in children with a high prevalence of peripheral tears that require repair. The MRI classification can aid surgeons in predicting the occurrence of peripheral tears and degree of instability as well as appropriately plan the treatment method preoperatively. Current treatment recommendations favour meniscal reshaping through partial meniscectomy with or without repair. However, arthroscopic reshaping can be challenging to an inexperienced surgeon because visualization within the lateral joint space may be limited by the thickened meniscus and the often small-sized paediatric knee. It is believed that the described technical guide to arthroscopic partial meniscectomy in conjunction with the meniscal repair of the peripheral tear is an effective treatment method in children.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 110-746, Republic of Korea

    Jin Hwan Ahn MD

  2. Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, South Korea

    Sang Hak Lee

  3. HKF – Center Hip-Knee-Foot Surgery, ATOS Hospital Heidelberg, Anatomical Institute, University of Heidelberg, Heidelberg, 69190, Germany

    Rainer Siebold

  4. Department of Orthopaedics and Sports Medicine Service, “Meir” Medical Center and Tel-Aviv University Hospital, Kfar-Saba, Israel

    Lior Laver

  5. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Lior Laver

Authors
  1. Jin Hwan Ahn MD
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  2. Sang Hak Lee
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  3. Rainer Siebold
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  4. Lior Laver
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Corresponding author

Correspondence to Jin Hwan Ahn MD .

Editor information

Editors and Affiliations

  1. Orthopaedics & Traumatology, Unit INSERM, Normandy University, Caen university Hos, Caen, France

    Christophe Hulet

  2. Orthopedic Department, Centro Hospitalar Póvoa de Varzim –Vila, Póvoa de Varzim, Porto, Portugal

    Helder Pereira

  3. University of Milan, Dpt. of Biomedical Sciences for Health, Milano, Italy

    Giuseppe Peretti

  4. Istituto Clinico Humanitas, Monza, Italy

    Matteo Denti

1 Electronic Supplementary Material

Video 25.1

The video clip of a 13-year-old girl shows physical examination with postero-central shift type of the discoid lateral meniscus in right knee. Large clunk is caused by movement of the entire discoid lateral meniscus that is shifted to the posterocentral direction during knee extension. A small click is caused by movement of the discoid lateral meniscus that is reduced to its anatomic position during knee full flexion. (MPG 13610 kb)

Video 25.2

The video clip shows arthroscopic finding of Video 25.1. The entire meniscus is moved to the posterocentral direction and anatomic position during knee extension and flexion. The meniscus repair with outside-in technique and partial meniscectomy can be performed in discoid lateral meniscus with anterior peripheral tear. (MPG 112748 kb)

Video 25.3

The video clip shows arthroscopic finding with anterocentral shift type of discoid lateral meniscus. The meniscus repair with all-inside technique and partial meniscectomy can be performed in discoid lateral meniscus with posterior peripheral tear. (MPG 64101 kb)

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Ahn, J.H., Lee, S.H., Siebold, R., Laver, L. (2016). Discoid Meniscus and Meniscoplasty in Children. In: Hulet, C., Pereira, H., Peretti, G., Denti, M. (eds) Surgery of the Meniscus. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49188-1_25

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  • DOI: https://doi.org/10.1007/978-3-662-49188-1_25

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49186-7

  • Online ISBN: 978-3-662-49188-1

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