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Wrisberg variant of the lateral discoid meniscus in children: review of the literature and presentation of case series

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The Wrisberg variant of the discoid lateral meniscus is a very rare disorder and is characterized by the hypermobility and instability of the meniscus caused by the absence of its posterior tibial attachment, with only its meniscofemoral junction (Wrisberg’s ligament) maintained, and inserted in the posterior horn of the meniscus. As a result, the posterior horn of the lateral meniscus is mobile; often subluxing into the joint.

Materials and methods

A total of eight skeletally immature patients with symptomatic Wrisberg variant of the discoid lateral meniscus were included in this study. Each knee was evaluated with MRI and arthroscopy. We graded unstable discoid menisci according to their discoid morphology (complete vs. incomplete), meniscal intra-substance degeneration, and the presence or absence of meniscal tears. All eight menisci were evaluated as degenerated with no meniscal tears. Five of them were evaluated as complete. Due to the severely degenerated meniscus, we considered it unnecessary to repair the detached posterior tibial ligament, so we performed a reshaping of the discoid meniscus, restoring a C-shape, excising the hypertrophied central part of the meniscus, and creating a posterior horn with a remaining rim of 6–8 mm. For evaluation of the knee function preoperatively and postoperatively we used the online International Knee Documentation Committee (IKDC) system. The purpose of this study is to emphasize the importance of MRI in identifying and revealing the unstable (Wrisberg variant) type of discoid meniscus in children.

Results

The mean patient age at the time of surgery was 8.25 ± 2.91 years (range 5–13 years). The average follow-up was 3.75 ± 0.46 years (range 3–4) years. The mean preoperative IKDC score was 22.37 ± 1.50 (range 21–25) points. The mean postoperative IKDC score was 80.50 ± 1.77 (range 79–84) points.

Conclusions

MRI is a valuable tool in the evaluation of the shape, stability, and consistency of symptomatic discoid menisci. It is helpful for the detection of the unstable Wrisberg variant.

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Authors and Affiliations

  1. A’ Orthopaedic Department, Athens General Children’s Hospital P. & A. Kyriakou, Thivon and Levadias, Ambelokipi, 11527, Athens, Greece

    Panos Megremis

  2. Mati Attiki, Greece

    Panos Megremis

  3. 6th Orthopaedic Department, General Peripheral Hospital of Attiki: Geniko Nosokomeio Attikes KAT, Athens, Greece

    Orestis Megremis

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by PM, and OM. The first draft of the manuscript was written by PM and OM commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Panos Megremis.

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The authors did not receive support from any organization for the submitted work. No funds, grants, or other support was received. The authors have no financial or proprietary interests in any material discussed in this article.

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This article does not contain any studies with animals performed by any of the authors. This study was performed in line with the principles of the 1964 Declaration of Helsinki.

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Megremis, P., Megremis, O. Wrisberg variant of the lateral discoid meniscus in children: review of the literature and presentation of case series. Arch Orthop Trauma Surg 143, 7107–7114 (2023). https://doi.org/10.1007/s00402-023-05021-7

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