ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Discoid lateral meniscus instability in children: part I. A new grading system of instability to clarify natural history.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Radiographic evaluation of key anatomical markers in discoid lateral meniscus: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- Anterior Peripheral Rim Instability Is Prevalent in Young, Skeletally Immature Patients With Discoid Lateral Meniscus and Has Favorable Postoperative Outcomes.Arthroscopy, sports medicine, and rehabilitation · 2025Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn young patients, the discoid lateral meniscus (DLM) usually becomes symptomatic at the time of peripheral rim instability of a complete discoid form. However, little is known about the natural history of meniscal instability. The aim was to detect hidden forms of presentation of instability using the history and clinical mechanical symptoms of instability.
methodsRetrospective study of 114 paediatric knees treated for DLM. A new clinical grading system for instability (stable, locked, snapping, blocked and unblocked knees) was defined and studied in combination with MRI and arthroscopic findings.
resultsOne hundred seven DLMs (94%) showed instability due to edge detachment. Fifteen (13%) knees were stable (grade 0), 2 (2%) were grade 1, 57 (50%) were grade 2, 35 (31%) were grade 3 and 5 (4%) were grade 4. The cause of grade 3 was an extension deficit (26/35) or flexion deficit (9/35). Grade 1 or 2 correlated with limited detachment, unlike grade 3 or 4. The grade of instability never decreased, but rather increased in many knees during the natural history of DLM.
conclusionA new presentation of DLM is presented: episodic locking phenomenon and blocked knee with flexion deficit. Clinicians should be wary of pseudo-improvement with the recovery of mobility after a period of the blocked knee, which may be due to a progression towards the ultimate degree of instability. Clinical grading of instability has clarified the natural history of DLM-associated tearing. LEVEL OF EVIDENCE: III.
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