Discoid Meniscus

Discoid Meniscus



Description


The meniscus is a cartilage structure in the knee that sits on top of the leg bone (tibia). Each knee has two menisci, an inner meniscus and an outer meniscus. These function as an adaptor between the rounded thigh bone (femur) and flat tibia and also help distribute the forces between the two bones over a greater area, rather than point to point. The meniscus helps supply nutrition to the cartilage that lines the bones (articular cartilage) and helps stabilize the knee. A discoid meniscus is a variant of the normal meniscus that some people are born with. Instead of being shaped like a cashew nut, the meniscus is more oval or disk shaped. Occasionally it has a normal shape with some abnormal attachment to the surrounding structures, which tends to occur in the outer (lateral) meniscus. The meniscus may cause symptoms without injury, or it can cause symptoms when torn or injured.



Common signs and symptoms



• Often asymptomatic

• Snapping or clunking of the knee with motion

• Pain, especially with standing on the affected leg, and tenderness along the joint of the knee

• Swelling of the knee noted 1 to 2 days after the injury, although it may occur right after the injury

• Locking of the knee (cannot straighten the knee completely)

• Giving way or buckling of the knee


Causes


The cause is unknown, but discoid meniscus is thought to be a developmental or congenital problem (a problem you are born with). It can occur in both knees in up to 10% of people with this condition.



Factors that increase risk



• Contact sports (football) and sports in which cleats are involved with pivoting (soccer) or sports in which good shoe grip and sudden changes in direction are required (racquetball, basketball)

• Previous knee injury

• Associated knee injury, particularly ligament injuries

• Poor physical conditioning (strength, flexibility)

• Race (occurs in up to 25% of Asians compared to a 5% incidence in Caucasians)


Preventive measures



• Appropriately warm up and stretch before practice or competition.

• Maintain appropriate conditioning that includes cardiovascular fitness and knee strength, flexibility, and endurance.

• For participation in jumping (basketball, volleyball) or contact sports, protect the knee joint with supportive devices, such as wrapped elastic bandages, tape, or braces (these have not been proven effective).

• Wear proper protective equipment and ensure correct fit, including cleats appropriate for the surface.


Expected outcome


Some meniscal injuries can heal on their own, and some do not heal but may not cause any symptoms. The only definitive treatment for meniscal tears is surgery, which may provide complete healing in 6 weeks. If there are no symptoms, there is no known problem with leaving the meniscus alone (no surgery).



Possible complications



• Frequent recurrence of symptoms, resulting in a chronic problem; appropriately addressing the problem the first time decreases the frequency of recurrence.

• Repeated knee injury, particularly if sports are resumed too soon after injury or surgery

• Progression to a larger tear if untreated

• Arthritis of the knee in later years (with removal of tear or without surgery)

• Complications of surgery, including infection, bleeding, injury to nerves (numbness, weakness, paralysis) continued pain, giving way, locking, need for further surgery, and knee stiffness and loss of motion


General treatment considerations


If the discoid meniscus is found incidentally and does not cause symptoms, nothing needs to be done. If injured, initial treatment consists of medications and ice to relieve pain and reduce the swelling of the affected joint. Using crutches until you can walk without a limp is sometimes recommended (you may put full weight on the injured leg). Range of motion, stretching, and strengthening exercises may be carried out at home, although referral to a physical therapist or athletic trainer may be recommended. Occasionally your physician may recommend a brace, immobilizer, or crutches to protect the joint. Arthroscopic surgery is often recommended as definitive treatment. Usually the tear is removed, although occasionally a repair may be attempted. After surgery or immobilization, stretching and strengthening of the injured, stiff, and weakened joint and surrounding muscles are necessary. Exercises may be done with or without the assistance of a physical therapist.

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Jul 18, 2016 | Posted by in SPORT MEDICINE | Comments Off on Discoid Meniscus

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