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Meniscus Variations

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Sports Injuries

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Abstract

The lateral meniscus is more variable than the medial meniscus morphologically regarding the size, thickness, shape, and mobility. The most common lateral meniscal variant is discoid in shape, which implies greater coverage of the tibia and usually increased thickness. Many stable lateral meniscal variants are asymptomatic and are found incidentally. The most common symptoms, which usually occur during childhood and adolescence, are a clunking sound with flexion of the knee, pain, a decreased range of motion, joint line tenderness, sensation of a foreign object within the knee, quadriceps atrophy, and effusion. Since it was first described, several classifications were proposed using clinical, radiologic, and arthroscopic findings. Although most of these classifications are descriptive, newer systems focus on influencing treatment. The treatment options for the various lateral meniscal variants include observation, partial meniscectomy with or without reattachment, total meniscectomy, and for a normally shaped unstable lesion reattachment to the adjacent capsule. It must be kept in mind that there may be no good treatment option; rather, the only choice may be the lesser of two evils. During arthroscopy a tear may not be visualized in some symptomatic discoid menisci. Therefore, a preoperative MRI is mandatory for all discoid menisci, because the absence and presence of shift and the direction of the shift must be carefully assessed before surgery since it alters the therapeutic approach. In the presence of a shift, the meniscus must be reduced before starting the excision. After resection, the tear in the opposite horn should be repaired with sutures. This chapter reviews the anatomy, embryology, etiology, and classification of discoid menisci as well as their clinical presentations, accompanying conditions, tears, and treatment.

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  1. Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Hasircilar Caddesi, 06100, Ankara, Sihhiye, Turkey

    Caglar Yilgor, Özgür Ahmet Atay & Mahmut Nedim Doral

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  1. Caglar Yilgor
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  2. Özgür Ahmet Atay
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  3. Mahmut Nedim Doral
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Correspondence to Caglar Yilgor .

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  1. Dept. Orthopedics & Traumatology, Hacettepe University Fac. Medicine, Ankara, Turkey

    Mahmut Nedim Doral

  2. Gothenburg, Sweden

    Jon Karlsson

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Yilgor, C., Atay, Ö.A., Doral, M.N. (2014). Meniscus Variations. In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_267-1

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  • DOI: https://doi.org/10.1007/978-3-642-36801-1_267-1

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