Hypermobile Meniscus: Difference between revisions
No edit summary |
(Added references) |
||
| Line 13: | Line 13: | ||
== Clinically Relevant Anatomy<br> == | == Clinically Relevant Anatomy<br> == | ||
Lateral meniscus hypermobility (LMH) is excess motion at the lateral meniscus that can cause lateral knee pain or tenderness, locking of the knee, or limitation of the range of motion during knee flexion. | Lateral meniscus hypermobility (LMH) is excess motion at the lateral meniscus that can cause lateral knee pain or tenderness, locking of the knee, or limitation of the range of motion during knee flexion. <ref name=":0">1. | ||
The menisci are crescent shaped, cartilaginous discs that lie between the articular cartilage of the femur and tibia. The menisci have various functions - load transmission, shock absorption, joint lubrication, nutrition, secondary mechanical stability, and guiding of movements. | Beel W, Macchiarola L, Mouton C, Laver L, Seil R. The hypermobile and unstable lateral meniscus: a narrative review of the anatomy, biomechanics, diagnosis and treatment options. Ann Jt [Internet]. 2022;7:14–14. Available from: <nowiki>http://dx.doi.org/10.21037/aoj-21-9</nowiki></ref><ref name=":1">4. | ||
<br>In a stable knee, the lateral meniscus is smaller, thinner, and more mobile than the medial meniscus. In addition, the lateral meniscus has less stabilizers at its posterolateral aspect. | |||
Kamiya T, Suzuki T, Otsubo H, Kuroda M, Matsumura T, Kubota C, et al. Midterm outcomes after arthroscopic surgery for hypermobile lateral meniscus in adults: Restriction of paradoxical motion. J Orthop Sci [Internet]. 2018;23(6):1000–4. Available from: <nowiki>http://dx.doi.org/10.1016/j.jos.2018.06.003</nowiki></ref> It is a rare, uncommon condition. <ref name=":0" /> | |||
The menisci are crescent shaped, cartilaginous discs that lie between the articular cartilage of the femur and tibia. The menisci have various functions - load transmission, shock absorption, joint lubrication, nutrition, secondary mechanical stability, and guiding of movements.<ref>Habegger A. The Knee. 2023 Mar.</ref>[[File:Meniscus sup view Gray349.png|center|thumb|Caudal view of right knee|alt=]] | |||
<br>In a stable knee, the lateral meniscus is smaller, thinner, and more mobile than the medial meniscus. In addition, the lateral meniscus has less stabilizers at its posterolateral aspect.<ref name=":0" /> The stabilizers of the lateral meniscus include the – popliteomeniscal fascicles (PMF), the posterior capsule, the meniscofemoral ligaments, and the posterior meniscotibial ligament. <ref name=":0" /> These attachments to the posterior knee prevent the subluxation of the posterior horn of the lateral meniscus into the knee joint. <ref name=":2">McHugh C. Hypermobile lateral Meniscus [Internet]. Orthosports. 2022 [cited 2023 Mar 28]. Available from: <nowiki>https://orthosports.com.au/hypermobile_lateral_meniscus</nowiki></ref> | |||
== Mechanism of Injury / Pathological Process<br> == | == Mechanism of Injury / Pathological Process<br> == | ||
LMH is thought to be related to a congenital deficiency in the capsular attachments ( | LMH is thought to be related to a congenital deficiency in the capsular attachments<ref>Van Steyn MO, Mariscalco MW, Pedroza AD, Smerek J, Kaeding CC, Flanigan DC. The hypermobile lateral meniscus: a retrospective review of presentation, imaging, treatment, and results. Knee Surg Sports Traumatol Arthrosc [Internet]. 2016;24(5):1555–9. Available from: <nowiki>http://dx.doi.org/10.1007/s00167-014-3497-0</nowiki></ref>, or an atraumatic injury to the ligamentous attachments<ref name=":2" />, specifically the PMF <ref name=":1" />. Trauma that causes rupture to the PMF can be insignificant, so patients may not recall a specific mechanism of injury. | ||
Commonly, hypermobility is due to an overuse injury, as well as atraumatic hypermobility. An isolated incidence of LMH is rare. Studies have found that in many cases of anterior cruciate ligament (ACL), and/or posterolateral injuries to the knee there is concurrent damage to the PMF, which may result in LMH. | Commonly, hypermobility is due to an overuse injury, as well as atraumatic hypermobility. An isolated incidence of LMH is rare. Studies have found that in many cases of anterior cruciate ligament (ACL), and/or posterolateral injuries to the knee there is concurrent damage to the PMF, which may result in LMH. | ||
Revision as of 16:22, 28 March 2023
Top Contributors - Robert Pierce, Madisyn Melchor, Kim Jackson, Matt Huey, Cindy John-Chu and Briana Marin
Top Contributors - Robert Pierce, Madisyn Melchor, Kim Jackson, Matt Huey, Cindy John-Chu and Briana Marin
Clinically Relevant Anatomy
[edit | edit source]
Lateral meniscus hypermobility (LMH) is excess motion at the lateral meniscus that can cause lateral knee pain or tenderness, locking of the knee, or limitation of the range of motion during knee flexion. [1][2] It is a rare, uncommon condition. [1]
The menisci are crescent shaped, cartilaginous discs that lie between the articular cartilage of the femur and tibia. The menisci have various functions - load transmission, shock absorption, joint lubrication, nutrition, secondary mechanical stability, and guiding of movements.[3]
In a stable knee, the lateral meniscus is smaller, thinner, and more mobile than the medial meniscus. In addition, the lateral meniscus has less stabilizers at its posterolateral aspect.[1] The stabilizers of the lateral meniscus include the – popliteomeniscal fascicles (PMF), the posterior capsule, the meniscofemoral ligaments, and the posterior meniscotibial ligament. [1] These attachments to the posterior knee prevent the subluxation of the posterior horn of the lateral meniscus into the knee joint. [4]
Mechanism of Injury / Pathological Process
[edit | edit source]
LMH is thought to be related to a congenital deficiency in the capsular attachments[5], or an atraumatic injury to the ligamentous attachments[4], specifically the PMF [2]. Trauma that causes rupture to the PMF can be insignificant, so patients may not recall a specific mechanism of injury.
Commonly, hypermobility is due to an overuse injury, as well as atraumatic hypermobility. An isolated incidence of LMH is rare. Studies have found that in many cases of anterior cruciate ligament (ACL), and/or posterolateral injuries to the knee there is concurrent damage to the PMF, which may result in LMH.
Clinical Presentation[edit | edit source]
Symptoms include painful popping or locking with the knee in flexion and/or external rotation. Pain can be reproduced through application of a varus force when the hip and knee are placed in flexion and external rotation (FABER).
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions
[edit | edit source]
add text here relating to management approaches to the condition
Differential Diagnosis
[edit | edit source]
· Bucket-handle Meniscal Lesion
· Anterior Cruciate Ligament (ACL Tear)
· Ligamentous Instabilities
· Articular Cartilage lesions
· Patellar Dislocation
· Patellar Pathology
Resources
[edit | edit source]
add appropriate resources here
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 1. Beel W, Macchiarola L, Mouton C, Laver L, Seil R. The hypermobile and unstable lateral meniscus: a narrative review of the anatomy, biomechanics, diagnosis and treatment options. Ann Jt [Internet]. 2022;7:14–14. Available from: http://dx.doi.org/10.21037/aoj-21-9
- ↑ 2.0 2.1 4. Kamiya T, Suzuki T, Otsubo H, Kuroda M, Matsumura T, Kubota C, et al. Midterm outcomes after arthroscopic surgery for hypermobile lateral meniscus in adults: Restriction of paradoxical motion. J Orthop Sci [Internet]. 2018;23(6):1000–4. Available from: http://dx.doi.org/10.1016/j.jos.2018.06.003
- ↑ Habegger A. The Knee. 2023 Mar.
- ↑ 4.0 4.1 McHugh C. Hypermobile lateral Meniscus [Internet]. Orthosports. 2022 [cited 2023 Mar 28]. Available from: https://orthosports.com.au/hypermobile_lateral_meniscus
- ↑ Van Steyn MO, Mariscalco MW, Pedroza AD, Smerek J, Kaeding CC, Flanigan DC. The hypermobile lateral meniscus: a retrospective review of presentation, imaging, treatment, and results. Knee Surg Sports Traumatol Arthrosc [Internet]. 2016;24(5):1555–9. Available from: http://dx.doi.org/10.1007/s00167-014-3497-0
