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Intrameniscal degeneration and meniscotibial ligament loosening are associated factors with meniscal extrusion of symptomatic discoid lateral meniscus

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to compare the amount of extrusion of the discoid lateral meniscus (DLM), which was symptomatic and required surgery, with normal meniscuses and asymptomatic DLMs and examine factors associated with the extrusion of symptomatic DLM.

Methods

Medical records of participants with DLM or normal lateral meniscus (LM) were retrospectively reviewed using magnetic resonance imaging (MRI). DLM cases were divided into symptomatic and asymptomatic groups. The midbody meniscal extrusion was measured using mid-coronal MRI. The association between meniscal extrusion and MRI findings, including the meniscofemoral ligament, meniscotibial ligament (MTL), intrameniscal signal intensity of the peripheral rim, meniscal shift, and skeletal maturity, was evaluated.

Results

Eighty-six knees with DLM (63 symptomatic) were included. The control group included 31 patients. The symptomatic group showed significantly greater meniscal extrusion (mean ± standard deviation symptomatic DLM: 1.0 ± 1.1 mm, asymptomatic DLM: 0.1 ± 0.4 mm, and normal LM: 0.3 ± 0.6 mm, P < 0.001) and had a significantly higher incidence of MTL loosening (P = 0.02) and intrameniscal signal (P < 0.001) than the other two groups. In the symptomatic group, multivariable linear regression analysis showed that MTL loosening [β = 1.45, 95% confidence interval (CI) 1.03–1.86, P < 0.001] and intrameniscal signal (β = 0.49, 95% CI 0.09–0.90, P = 0.002) were independent associated factors.

Conclusions

LM extrusion was significantly more common in patients with symptomatic DLM than in those with asymptomatic DLM or a normal LM. MTL loosening and intrameniscal high-signal intensity on MRI were independently associated with meniscal extrusion. These findings help explain the pathogenesis and diagnosis of symptomatic DLM.

Level of evidence

III.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan

    Kazuya Nishino, Ken Iida & Takuya Kinoshita

  2. Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Yusuke Hashimoto & Hiroaki Nakamura

Authors
  1. Kazuya Nishino
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  2. Yusuke Hashimoto
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  3. Ken Iida
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  4. Takuya Kinoshita
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Contributions

KN: conception and design. Drafting of the article. YH: conception, and critical revision of the article for important intellectual content. KI: revising the manuscript and data collection. TK: interpretation of data. HN: conception and design, final approval of the article.

Corresponding author

Correspondence to Yusuke Hashimoto.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee (No. 2728).

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Informed consent was obtained from all the participants included in the study.

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Nishino, K., Hashimoto, Y., Iida, K. et al. Intrameniscal degeneration and meniscotibial ligament loosening are associated factors with meniscal extrusion of symptomatic discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 31, 2358–2365 (2023). https://doi.org/10.1007/s00167-022-07161-6

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