Preoperative Determination of the Resection Margin using MRI in the Treatment of Symptomatic Discoid Meniscus

Shin, Dong Bae; Lee, Young Soo; Park, Soo Jin; Kim, Jin Yong; Sung, Young Jea; Ha, Du Hae

Abstract

PURPOSE: Authors pursuit the meaningful guide for doing arthroscopic meniscetomy in the treatment of symptomatic discoid meniseus of the knee by determining the needed resection margin(partial or total) from the schematic diagram of degeneration and tear which is based on pre-operative MRI.
MATERIALS AND METHODS
We analyzed the findings of MRI and operation retrospectively for 32 knees. At first, we designed authors own schematic diagram of discoid meniscus and divided it into 6 x 6 block. The radiologists draw the pattern of degeneration and tear on diagram from pre-operative MRI and the orthopedic surgeons draw the status of degeneration, tear and remaining meniscus after meniscetomy by retrospective analysis of video documentation. Two diagrams were compared for analysis.
RESULTS
We had used morselization technique to save meniscus as much as possible on doing meniscetomy. The resected margin of cases were as follows; 9 cases were partial, 21 cases were subtotal and 2 cases were total meniscetomy. But in this study, 19 cases were requested total resection margin on pre-op MRI evaluation. Among these 19 cases, 17 cases of partial or subtotal meniscetomized were reviewed again on video documentation to determine the remained meniscus would be removed completely or not. In 13 of 17 cases, remaining menisci have advanced horizontal tear and rims were not stable that would be rather cases of total meniscetomy.
CONCLUSION
Use of diagram of degeneration and tear on the basis of pre-op MRI would be valuable guide to determine appropriate resection margin and moreover the technique of the meniscetomy in the treatment of symptomatic discoid meniscus.