Physical Therapy Following Saucerisation of Discoid Meniscus – a Case Study

Introduction: Discoid meniscus is a structure with altered shape, which causes it to frequently undergo injuries and lesions. Pain, limping, limited range of motion of the knee joint and swelling are characteristic signs of this pathology. Therapeutic possibilities include meniscectomy and saucerisation. Research objective: The study aim was assessment of the therapeutic effectiveness in a patient after saucerisation of discoid meniscus. Material and methods: A 12-year-old female patient after saucerisation of lower left limb lateral discoid meniscus (type I) was subjected to 32-week physical therapy treatment. Testing included determining the range of knee joint flexion and extension movements, as well as measuring the circumference of the lower extremities 15 cm above the patella. The Kujala Score (Anterior Knee Pain Scale) and Ikeuchi grading system were employed during the 1st, 3rd, 8th, 21st and 32nd weeks postoperatively. Results: In the final stage of physical therapy, complete range of knee joint motion was achieved, the Kujala Scale score totalled 98 points and the thigh circumference of the operated limb increased by 4 cm. The circumferences of the lower extremities differed by 2 cm in the final phase of physical therapy. Conclusions: The employed postoperative protocol effectively influenced the functional state of the patient.

The Relationship Between Discoid Meniscus and Articular Cartilage Thickness: A Quantitative Observational Study With MRI

Background: Several cadaveric imaging studies have demonstrated that the articular cartilage thickness on the tibial plateau varies depending on coverage by native meniscal tissue. These differences are thought to partially contribute to the rates of cartilage degeneration and development of osteoarthritis after meniscectomy. Because there is greater tibial plateau coverage with meniscal tissue in the setting of a discoid meniscus, these findings may also have implications for the long-term health of the knee after saucerization of a torn discoid meniscus. Purpose: To evaluate the relationship between lateral compartment articular cartilage thickness and the presence or absence of a discoid meniscus. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included in the study were 25 patients younger than 40 years of age who had undergone a 1.5-T or 3-T knee magnetic resonance imaging (MRI) between 2010 and 2016 at a single institution and had an intact, lateral discoid meniscus. Only patients with an otherwise asymptomatic lateral compartment were included. The authors then identified 35 age-matched controls with a nondiscoid, intact lateral meniscus who underwent knee MRI at the same institution and during the same period. The articular cartilage thicknesses in 6 zones of the lateral femoral condyle (LFC) and lateral tibial plateau (LTP) were measured for each patient by 2 musculoskeletal radiologists, and the mean thicknesses were compared between the study and control groups. Results: The average age at MRI was 22.63 years (range, 8.30-35.90 years) for the discoid group and 20.93 years (range, 8.43-34.99 years) for the nondiscoid group. The nondiscoid group had significantly greater mean articular cartilage thickness in all 6 zones of the LTP ( P < .05 for all). When comparing the zones of the LFC, there was no significant difference in the mean thickness in any zone between the 2 groups. Conclusion: Patients with discoid menisci had thinner baseline articular cartilage thickness in the LTP compared with those patients without discoid menisci.