Altı yaşındaki kız hastada diskoid lateral menisküsün kova sapı yırtığı
Altı yaşındaki kız hasta, uzun süredir sağ dizde devam eden rahatsızlık ve atlama hissinden sonra, belirgin bir travma olmaksızın dizde ağrı, şişme ve kilitlenme gelişmesi üzerine kliniğimizde incelendi. Manyetik rezonans görüntülemede, tüm lateral platoyu dolduran, yapısal dejenerasyon gösteren lateral diskoid menisküs saptandı. Artroskopik inceleme sırasında diskoid lateral menisküsün kova sapı şeklinde yırtıldığı görülerek hastaya artroskopik subtotal menisektomi uygulandı. Birinci ay kontrolünde hastanın hareket sınırları tam, yürüyüşü normaldi. Üçüncü yıl takibinde ağrı, takılma ve atlama hissi olmaksızın tam hareket açıklığı sürüyordu. Hastaya, eklem dejenerasyonu gelişme olasılığı açısından uzun dönemli takip önerildi.
Bucket-handle tear of a discoid lateral meniscus in a 6-year-old girl
A six-year-old girl was examined upon development of pain, swelling, and locking in her right knee after a considerable period of discomfort and popping sensation. She had no history of trauma. Magnetic resonance imaging showed a discoid lateral meniscus, filling the entire lateral plateau and exhibiting signs of degeneration. On arthroscopic examination, a bucket-handle tear of the discoid lateral meniscus was noted and the patient was treated with arthroscopic subtotal meniscectomy. During the first month of follow-up, the patient had a full range of motion and normal gait. At three years, she maintained full range of motion without pain, locking, or popping. Due to the likelihood of joint degeneration, long-term follow-up was recommended.
___
- 1. Watanabe M, Takeda S, Ikeuchi H, editors. Discoid menisci. In: Atlas of arthroscopy. 3rd. ed. Tokyo: Igaku-Shoin; 1979. p. 88.
- 2. Good CR, Green DW, Griffith MH, Valen AW, Widmann RF, Rodeo SA. Arthroscopic treatment of symptomatic discoid meniscus in children: classification, technique, and results. Arthroscopy 2007;23:157-63.
- 3. Youm T, Chen AL. Discoid lateral meniscus: evaluation and treatment. Am J Orthop 2004;33:234-8.
- 4. Alford JW, Lewis P, Kang RW, Cole BJ. Rapid progression of chondral disease in the lateral compartment of the knee following meniscectomy. Arthroscopy 2005;21:1505-9.
- 5. Atay OA, Doral MN, Leblebicioğlu G, Tetik O, Aydıngöz U. Management of discoid lateral meniscus tears: observations in 34 knees. Arthroscopy 2003;19:346-52.
- 6. Dai L, Zhang W, Xu Y. Meniscal injury in children: longterm results after meniscectomy. Knee Surg Sports Traumatol Arthrosc 1997;5:77-9.
- 7. Kim SJ, Chun YM, Jeong JH, Ryu SW, Oh KS, Lubis AM. Effects of arthroscopic meniscectomy on the longterm prognosis for the discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc 2007;15:1315-20.
- 8. Kelly BT, Green DW. Discoid lateral meniscus in children. Curr Opin Pediatr 2002;14:54-61.
- 9. Tözün R, Arıtamur A, Başkır O, Türkmen M, Sözen YV, Kara AN, et al. Lateral discoid menisus in children. [Article in Turkish] Acta Orthop Traumatol Turc 1982;16:20-6.
- 10. Gür S, Tanker U, Akyıldız FF, Aydın AT, Altınel E. Arthroscopic management of the discoid lateral meniscus. [Article in Turkish] Acta Orthop Traumatol Turc 1996; 30:33-5.
- 11. Jordan MR. Lateral meniscal variants: evaluation and treatment. J Am Acad Orthop Surg 1996;4:191-200.
- 12. Kim YG, Ihn JC, Park SK, Kyung HS. An arthroscopic analysis of lateral meniscal variants and a comparison with MRI findings. Knee Surg Sports Traumatol Arthrosc 2006;14:20-6.
- 13. Clark CR, Ogden JA. Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg [Am] 1983;65:538-47.