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Morphological Analysis of Discoid Lateral Meniscus on Magnetic Resonance Imaging Comparing Pre- and Postoperative Images

Morphological Analysis of Discoid Lateral Meniscus on Magnetic Resonance Imaging Comparing Pre- and Postoperative Images

Shunya Tsuji, MD, JAPAN Masakazu Ishikawa, MD, PhD, JAPAN Naofumi Hashiguchi, MD,MPH, JAPAN Goki Kamei, MD, PhD, JAPAN Atsuo Nakamae, MD, PhD, JAPAN Nobuo Adachi, MD, PhD, JAPAN

Hiroshima University Hospital, Hiroshima, Hiroshima, JAPAN


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Sports Medicine


Summary: changes of the anterior-posterior diameter of the lateral meniscus to the medial meniscus ratio (ap-LMR) was depending on the shape of DLM and surgical procedure.


Purpose

We have reported that the anterior-posterior diameter of the lateral meniscus to the medial meniscus ratio (ap-LMR) on 3D MRI sagittal section is significantly smaller in patients with discoid lateral meniscus(DLM) than those with normal lateral meniscus cases. The purpose of this study was to evaluate the changes in ap-LMR in DLM before and after surgery.

Methods

Among DLM patients who underwent arthroscopic surgery at our hospital between 2011 and 2020, 64 knees in 57 cases (32 males and 32 females, mean age 17.3 years) were included in the study for whom MRI was obtained before and after the surgery. The ap-LMR was calculated on simple MRI sagittal images and compared before and after surgery. The difference of ap-LMR in the complete and incomplete DLM groups, and in the only saucerization groups and saucerization plus suture groups were compared.

Results

The ap-LMR increased significantly from 69.5±8.2% preoperatively to 76.0±7.6% postoperatively (p<0.01). The preoperative difference between the complete and incomplete DLM groups was not significant (complete: 69.1±7.1%, incomplete: 69.6±9.0%, p=0.53). However difference was significantly greater in the complete DLM group postoperatively (complete: 79.0±7.6%, incomplete: 73.8±6.9%, p=0.03). In comparison of surgical techniques, there was no significant difference between the two groups preoperatively (partial resection group: 71.4±9.2%, partial resection + suture group: 68.7±7.7%, p=0.19), but postoperatively, saucerization + suture group showed significantly smaller values (saucerization group: 80.0±7.9%, saucerization + suture group: 74.6%±7.0%, p=0.04).

Discussion

The postoperative ap-LMR increased in DLMs, suggesting that the postoperative shape causes a change in load distribution and an increase in the anteroposterior diameter. ap-LMR changes differed depending on the morphology of the DLM and whether it was sutured or not, suggesting that the difference in the hoop function of the DLM may cause the anteroposterior diameter to change.

Conclusion

Moreover, changes of ap-LMR was depending on the shape of DLM and surgical procedure.


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