Evolution of Osteochondritis Dissecans of the Lateral Femoral Condyle Combined with Discoid Meniscus

Abstract

The discoid meniscus is a rare anomaly of the knee that affects mostly the lateral meniscus and is often asymptomatic. The osteochondritis dissecans is a disorder of the subchondral bone and articular cartilage and occurs frequently associated with the discoid lateral meniscus. In the present case, we showed the evolution of this association related to surgical treatment. A patient with lateral knee pain and a magnetic resonance depicting a torn discoid lateral meniscus and osteochondritis dissecans of the lateral femoral condyle was treated with partial meniscectomy and meniscal sutures. After 1 year, the symptoms reappeared, and a new meniscal repair was performed to treat a bucket-handle tear, while cartilage was apparently intact. After 4 years, there was a new recurrence of symptoms, and the knee developed a valgus deformity. Cartilage was treated with microfractures, and a subsequent distal femoral osteotomy associated with lateral meniscal scaffold was performed. The patient was followed up clinically, with radiographs and magnetic resonance for 5 years with an improvement of the results up to 2 years and no signs of deterioration of results over time.

Osteochondral Allograft for Unsalvageable Osteochondritis Dissecans in the Skeletally Immature Knee

“…Of lateral femoral condyle lesions, 33% were seen with a discoid meniscus in the affected compartment, an association described in the literature that may require concurrent or secondary arthroscopic treatment. 9,23,45 The need for realignment procedures in this population was consistent with a significant association demonstrated between mechanical axis deviation and osteochondral defect presence in the affected compartment. 28 Malalignment has been demonstrated as a risk factor for graft failure.…”

“…Of lateral femoral condyle lesions, 33% were seen with a discoid meniscus in the affected compartment, an association described in the literature that may require concurrent or secondary arthroscopic treatment. 9 , 23 , 45 …”

“… 28 Malalignment has been demonstrated as a risk factor for graft failure. 9 Both growth modulation and realignment osteotomies, for patients with open and closed physes, respectively, may result in additional planned reoperations for elective hardware removal, as is routine practice in the pediatric population. Planned removal in this cohort also included both extra-articular and intra-articular (headless graft compression screws) hardware.…”

An adult case of spontaneous healing of concurrent osteochondritis dissecans of the lateral femoral condyle after saucerization with meniscal repair for discoid lateral meniscus: A case report

“…They emphasized that meniscal stabilization was effective in the treatment of OCD. Bulgheroni et al reported a case of OCD development after re-tear of DLM [ 17 ]. They mentioned the importance of preserving the peripheral meniscal rim.…”