scholarly journals Benign Neglect of Anomalous Insertion of the Anterior Horn of the Medial Meniscus as an Incidental Finding During Knee Arthroscopy

2020 ◽  
Vol 2 (1) ◽  
pp. e1-e6
Author(s):  
Masaki Nagashima ◽  
Toshiro Otani ◽  
Kenichiro Takeshima ◽  
Hiroyuki Seki ◽  
Ken Ishii
2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098153
Author(s):  
Peng Chen ◽  
Pengzhou Huang ◽  
Yuxiang Ren ◽  
Guanwei Jiang ◽  
Wentao Zhang ◽  
...  

Objective To gain a greater understanding of anomalous insertions of the anterior horn of the medial meniscus through evaluation of a rare case and a review of the existing literature on medial meniscus malformations. Methods This report describes a 26-year-old man with an anomalous insertion of the anterior horn of the medial meniscus combined with symptomatic hypertrophy of the anterior horn and a synovial cyst. We also conducted a review of the existing literature on medial meniscus malformations using five major scholarly literature databases and search engines. Results The literature review revealed that the incidence of anomalous insertions of the anterior horn of the medial meniscus is 0.5% to 2.8%. Not all patients undergo surgical excision; some are only symptomatically treated. In our patient, the arthroscopic view was consistent with the imaging characteristics. No special operation was performed to treat the anomalous insertion. At the 18-month follow-up, the patient had no symptom recurrence and had returned to practicing sports. Conclusion The pain during hyperextension in our patient was caused by a cyst and anterior horn hypertrophy. If the symptoms in such cases are not caused by the anomalous insertion, no special treatment is needed.


2016 ◽  
Vol 58 (4) ◽  
pp. 464-471 ◽  
Author(s):  
Tineke De Coninck ◽  
Frederik Vanrietvelde ◽  
Patrick Seynaeve ◽  
Peter Verdonk ◽  
Koenraad Verstraete

Background In cadaveric and arthroscopic studies different insertion locations of the anterior horn of the medial meniscus (AHMM) have been described. Purpose To investigate if the different insertion locations of the AHMM, as described in cadaveric studies, can be determined on magnetic resonance imaging (MRI). Material and Methods MR images of 100 patients without meniscal tears on MRI were retrospectively evaluated. Two observers classified the AHMM insertion based on its position relative to the anterior tibial edge and the medial tibial spine. The association between AHMM insertion and tibial plateau slope, meniscal radial displacement, and anterior intermeniscal ligament (AIL) presence was investigated. Results The AHMM inserted posterior to the anterior tibial edge in 93 knees and anterior to the tibial edge in seven knees (= type III). Of the 93 knees with AHMM insertion posterior to the anterior tibial edge, 63 inserted lateral to the medial tibial spine (= type I) and 30 medial (= type II). The AHMMs inserting anterior to the tibial edge had a significantly ( P < 0.05) steeper anterior tibial plateau slope and a significantly ( P < 0.05) higher presence of the AIL. No significant difference in radial displacement was observed between the three insertion types ( P > 0.05). A strong inter- and intra-observer agreement was observed. Conclusion Three different bony insertion locations of the AHMM, as described in cadaveric studies, could be identified on MRI. All AHMMs inserting anterior to the tibial edge displayed an AIL. Whether there is a clinical correlation with these insertion patterns remains unclear.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Pier Paolo Mariani ◽  
Michael J Battaglia ◽  
Guglielmo Torre

Abstract Background Anatomical variations of the attachment of medial meniscus are a common finding. However, anomalies of the posterior horn are extremely rare. Only two cases of posterior root anomaly have been described prior to the routine use of arthroscopy for evaluation and treatment of meniscal pathology. In this report, we present an anomaly of both the anterior and posterior roots of the medial meniscus that posed both a diagnostic and therapeutic dilemma. Case presentation The patient is young male soccer player who is currently 16 years of age and began having the atraumatic onset of pain and symptoms that limited performance starting at age 14 and was referred for failure of response to nonoperative treatment. Diagnostic arthroscopy revealed the presence of an anteromedial meniscofemoral ligament whereas the posterior root showed no bony attachment. The radiographic and arthroscopic findings are described. The clinical decision was made after to proceed with observation, reassurance, and gradual return to full activity with physiotherapy guidance. Discussion and conclusion The absence of injury, the mild complaints reported by the patient, his age, skeletal immaturity, and remaining growth led us to adopt a conservative approach to treating this anatomic variant and currently the patient is able to participate fully in sports without symptoms or restrictions.


2021 ◽  
Author(s):  
Guorong Jin ◽  
Tong Xin ◽  
Zheng Weng ◽  
Yun Zhu ◽  
Hao Qiu ◽  
...  

Abstract Rationale: Complete discoid medial meniscus is an extremely rare abnormality of the knee joint whose meniscus has a discoid shape rather than a normal semilunar one. Several medial meniscus anomalies including anomalous insertion have been reported in the literature. This report presents a rare case of symptomatic complete discoid medial meniscus whose anterolateral (apical) portion was completely coalesced with the ACL. MRI, radiographic and arthroscopic findings in the medial compartment are to be submitted.Patient concerns and diagnoses: A 29-year-old male presented with intermittent pain and swelling of the right knee for 2 years. Based on radiographic, MRI and physical examination findings, he was diagnosed with discoid medial meniscus tears. Interventions and outcomes: Arthroscopic saucerization were performed for the torn discoid medial meniscus of the right knee. Arthroscopic examination revealed a complete discoid medial meniscus and the anterolateral (apical) portion of which was completely coalesced with the ACL. Careful Probing of the meniscal surface revealed there was a longitudinal tear extending from the tibial spine to the midportion of the meniscus. Arthroscopic saucerization of the discoid meniscus were performed After closely cutting the meniscus around the ACL. The patient reported a satisfactory results at the 12-month follow-up.Lessons: Complete discoid medial meniscus is an extremely rare abnormality, and this case presents the third complete discoid medial meniscus whose anterolateral (apical) portion was completely coalesced with the ACL. The current case we present strongly supports the theory that ACL and meniscus were differentiated from the same mesenchyme.


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