Prevalence and Correlation Analysis of Lateral Discoid Meniscus with Degeneration or Injury of the Meniscus and Articular Cartilage in the Entire Tibiofemoral Joint

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However, it is important to note that an unfavorable biomechanical environment caused by DM not only leads to self-injury but also has a significant impact on adjacent structures. Therefore, the aim of this study was to investigate the relationship between DM and injuries in both the meniscus and cartilage within the total tibiofemoral joint(TJ). Methods Patients undergoing knee magnetic resonance imaging (MRI) examinations at our outpatient clinic were screened, and a total of 278 patients were enrolled in the DM group, with 279 patients in the non-discoid meniscus (NDM) group. The type of DM was classified according to the Watanabe classification, while meniscal and articular cartilage injuries were classified using the Stoller and Hepple classifications, respectively. The prevalence of DM and injuries to the meniscus and articular structures within the TJ in the general population was assessed, along with their relationship. Results The prevalence of DM was 8.5%, while the incidence of TJ injury was 10%. Notably, the DM group exhibited a significantly higher incidence of TJ injury (P <0.001). Among the cases, there were 93 patients with type I DM and 185 patients with type II DM. Specifically, the type I DM group showed a significantly higher percentage of lateral meniscus injuries (P <0.005), whereas the type II DM group demonstrated a significantly higher percentage of medial TJ injuries (P <0.005). Conclusion Discoid meniscus is associated with a higher risk of degeneration or injury to both the meniscus and articular cartilage of the tibiofemoral joint. Specifically, Type I discoid meniscus is particularly susceptible to tears, whereas Type II discoid meniscus tends to remain intact over a broader age range but is more prone to degeneration or injury of the medial meniscus and articular cartilage. Study design Retrospective study. Discoid meniscus Degeneration Prevalence Congenital malformation Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Discoid meniscus (DM) is a congenital morphological anomaly predominantly affecting the lateral meniscus [ 1 – 7 ], first documented in 1889 by Young through cadaver dissection [ 8 ]. Its prevalence is notably higher in Asian populations (10–15%) compared to Western populations (3–5%) [ 1 , 3 , 5 , 9 , 11 , 12 , 13 ]. Due to its atypical shape and structure, the disc-shaped meniscus is more susceptible to injury. Moreover, the presence of a discoid meniscus disrupts the balance of the knee joint, leading to uneven force distribution across the tibiofemoral joint(TJ) surface. This inevitably influences physiological and pathological changes in the entire TJ, particularly affecting the medial and lateral menisci as well as the articular cartilage, thereby causing adverse effects. To the best of our knowledge, there is insufficient research analyzing the impact of discoid menisci on the TJ as a whole, with specific emphasis on the medial TJ. Therefore, this study aims to investigate the incidence of various types of discoid menisci and their potential effects on the overall TJ surface using magnetic resonance imaging (MRI). Moreover, injury rates differ between type I and type II discoid menisci due to variations in their histological structure and morphology [ 15 ]. This may result in TJ injuries in other areas before the DM itself is damaged, a condition that is often overlooked by sports medicine practitioners. This study screened 3,253 patients who underwent MRI scanning in the outpatient department of our hospital. The prevalence of DM among these patients was 8.5%, and TJ injury was analyzed in a cohort with a mean age of 40.3 years (range, 8–73 years). Methods Study population:This retrospective study was approved by our institution's review board. From December 2023 to November 2024, 3253 patients undergoing knee MRI examinations at our outpatient clinic were screened. Patients with a lateral discoid meniscus were included in the DM group. For a sex- and age-matched non-discoid meniscus (NDM) group, patients were selected from the remaining subjects, excluding those with syndromic diagnoses such as Marfan syndrome, Ehlers-Danlos syndrome, etc., autoimmune diseases (e.g., rheumatoid arthritis), metabolic diseases (e.g., gout), cerebral palsy, joint hypermobility syndrome, fractures, ligament injuries, or prior knee surgeries. MRI examination and measurement: All patients were examined using the same imaging modality (GE Signa Pioneer, 3.0-T, slice thickness: 3.0 mm). The images were reviewed by two musculoskeletal (MSK) radiologists to define the injury types of the meniscus and articular cartilage. In cases of discrepancy, a secondary independent review was conducted by the original reviewers, followed by resolution through majority vote by a five-member panel consisting of two sports medicine surgeons and three MSK radiologists. Discoid meniscus: The type of DM was classified on the coronal and sagittal planes of MRI using the Watanabe classification. DM is diagnosed if any of the following conditions are met: (1) the minimum width of the midsegment of the meniscus on the coronal slice is ≥ 15 mm; (2) the ratio of the minimum meniscal width to the maximum tibial plateau width on the coronal slice is ≥ 20%; (3) the ratio of the combined width of the anterior and posterior horns to the maximal meniscal diameter on the sagittal slice displaying the largest meniscal diameter is ≥ 75%. [ 7 , 14 , 22 , 29 , 30 ] Meniscus and Joint Cartilage Injury: The Stollar classification system is used to grade meniscus injuries. Grade 0: A normal meniscus, characterized by a homogeneous low signal intensity and regular morphology. Grade I: Intra-meniscal punctate or speckled high-signal areas are observed, but do not connect to the joint surface. Grade II: Linear high-signal areas are present within the meniscus, extending to the meniscus-capsule junction, but not reaching the articular surface. Grade III: High-signal areas within the meniscus extend to the articular surface, indicating various types of meniscus tears, meniscus-capsule detachment, and meniscus cysts. When multiple signals are present, only the highest-grade signal is recorded. The Hepple classification system is used for grading cartilage injuries. Grade 1: Isolated joint cartilage injury. Grade 2: Joint cartilage injury with an associated subchondral fracture, regardless of the presence or absence of surrounding bone marrow edema. Grade 3: Separated bone fragments that are not displaced. Grade 4: Separated and displaced bone fragments. Grade 5: Formation of subchondral cysts within the joint cartilage. When multiple signals are present, only the highest-grade signal is recorded. [ 8 , 10 , 16 , 20 , 21 , 24 , 33 , 34 , 35 ] Statistical analysis: Statistical analyses were conducted using SPSS version 26.0. The Kolmogorov-Smirnov test was employed to assess the normality of the data. For normally distributed data, ANOVA was utilized; for non-normally distributed data, the independent samples Kruskal-Wallis test and Mann-Whitney U test were applied. The Chi-square test was used to examine the association between DM and TJ injury When required, Fisher's exact test and Bonferroni correction were performed, with a significance level set at 0.05. Results A total of 3253 patients were screened, and 278 were included in the DM group, corresponding to an incidence rate of 8.5%. An additional 279 patients were matched by sex and age to form the NDM group. The inclusion criteria and the number of patients are summarized in Figure 1. Table 1 provides the baseline characteristics of both groups. The frequency and distribution of injuries in the two groups are detailed in Table 2. The overall incidence of injuries was significantly higher in the DM group compared to the NDM group (P < 0.05). Specifically, the DM group exhibited a significantly higher percentage of medial tibiofemoral articular cartilage and meniscus injuries compared to the NDM group (P < 0.001). Table 1 Descriptive Statistics for Patient Demographics Variables Non-Discoid Meniscus Discoid Meniscus Patients, n Age, median (range) Sex Female, n (%) Male, n (%) Side Left, n (%) Right, n (%) 279 40 (8–71) 153 (55%) 126 (45%) 144(52%) 135(48%) 278 41 (9–73) 150(54%) 128 (46%) 142 (51%) 136 (49%) A total of 279 patients were enrolled in the sex- and age- matched NDM group. Table2 The incidence of meniscus and articular cartilage degeneration or injury in the DM and NDM groups NON-L LML MML LAL MAL L.Total M.Total DM 47(17%) 88(32%) 94(34%) 5(2%) 44(16%) 93(26%) 138 (34%) NDM 180(65%) 29 (10%) 31(11%) 18(6%) 21(8%) 47(17%) 52(19%) The highest level of degeneration or injury of articular cartilage and meniscus of medial and lateral TJ was counted in the DM and NDM groups . NON-L none of the lesions,LML lateral meniscus lesions,MML medial meniscus lesions,LAL lateral articular lesions,MAL medial articular lesions,L.Total total lateral lesions,M.Total total medial lesions Among the DM group, there were 93 cases of type I DM and 185 cases of type II DM, with no cases of type III DM. The number and proportion of injuries at different anatomical positions in each DM group are presented in Table 3. The overall incidence of TJ injury did not differ significantly between the two groups (P = 0.971). However, the proportion of medial tibiofemoral joint injuries was significantly higher in the type II DM group compared to the type I DM group (P < 0.001). Additionally, the incidence of lateral meniscus injury was significantly higher in the type I DM group compared to the type II DM group (P < 0.001). Table3 The incidence of meniscus and articular cartilage degeneration or injury in each type of DM group NON-L LML MML LAL MAL L.Total M.Total TypeⅠDM 12(13%) 58(63%) 11(12%) 3(3%) 9(10%) 61(66%) 20 (22%) TypeⅡDM 35(19%) 30(16%) 83(45%) 2(1%) 35(19%) 32(17%) 118(64%) The highest level of degeneration or injury of articular cartilage and meniscus of medial and lateral TJ was counted in the TypeⅠDM and TypeⅡDM groups . NON-L none of the lesions,LML lateral meniscus lesions,MML medial meniscus lesions,LAL lateral articular lesions,MAL medial articular lesions, L.Total total lateral lesions,M.Total total medial lesions Discussion Discoid meniscus (DM) was initially reported by Young in 1889 during cadaver dissection[8]. It is commonly observed, with an approximate incidence rate ranging from 0.4% to 17%. However, discoid medial meniscus is seldom detected, with an incidence of 0.06% to 0.3%. A higher prevalence has been noted in Asian populations (10–15%) compared to Western populations (3–5%). Bilateral involvement is witnessed in 15–25% of the patients with DM. [1,3,5,9,11, 12,13,18,23,28,32] The diagnosis and treatment of DM have been extensively discussed in the literature. However, there is a dearth of comprehensive studies on its impact on the entire TJ. In the early stages, DM often remains asymptomatic, particularly in type II DM, whose symptoms are more subtle.Nevertheless, long-term biomechanical abnormalities can give rise to damage in both lateral and medial structures of the TJ during movement. [2, 4, 6, 17,19,25] To facilitate calculations, simplify the knee joint into a geometric figure (Fig.2)，assuming that the internal and external condyles of the femur are equal in size spherically, while the tibial plateau remains parallel to the horizontal line，additionally assuming that the gravity line and lower limb force line is perpendicular to the horizontal line. The disc-shaped meniscus elevates the lateral condyle of femur and increases lateral TJ space, causing additional shear forces on the medial component which often results in strain on synovial edge (Fig.3). At the same time，with an inward tilt of gravity line, stress per unit area increases on medial tibial plateau while it decreases on lateral plateau, the medial and lateral articular cartilage and meniscus of TJ will be subjected to this pressure change. Relying on simple mechanical principles, we can get the above results. Furthermore, authors have identified variations in the histologic structure between type I and type II DM [15], suggesting potential differences in their strength and hardness. This discrepancy may explain the increased susceptibility of type I DM to tearing, while type II DM tends to demonstrate greater durability over extended periods. These findings align with empirical observations indicating that acute tears frequently occur in type I DM, whereas chronic damage to the medial structure is commonly associated with type II DM. This suggests that under an imbalanced pressure environment, the lateral type II DM exhibits resistance to pressure, while the medial synovial edge experiences strain due to compression and shear forces. [14,16,26,27,31] To validate the impact of the DM on dynamics TJ, we devised an experiment comprising a series of elastosonography assessments conducted on the static knee meniscus ,the knee positions include the no-load position, weight-bearing kneeling position, and weight-bearing knee extension position(Fig.4-6). The meniscus hardness was assessed using elastosonography in both a healthy volunteer and a patient with type 2 disk meniscus. Our findings revealed variations in meniscus hardness between the two subjects. There was no significant difference in the hardness of the medial and lateral meniscus in the healthy volunteer. However, during load-bearing kneeling positions,the patient with type II DM exhibited greater hardness in the medial meniscus compared to the lateral meniscus. Notably, maximum hardness was observed in the posterior corner of the medial meniscus during load-bearing kneeling positions for type II DM patients（Table4）. The findings of this experiment suggest that type II DM leads to biomechanical abnormalities within the knee joint, specifically resulting in the transmission of pressure towards the posterior corner of the medial meniscus. Table4 Meniscus elastic ultrasound measurements (kpa) in a healthy volunteer and a patient with type II DM Elastic ultrasonic measurement（kPa）of meniscus No-load test Straighten knee in gravity Bending knee in gravity DML bm 38 47 51 am 69 53 36 pm 31 40 42 DMM bm 31 59 91 am 30 83 104 pm 37 54 101 NL bm 56 53 -- am 85 27 24 pm 58 53 99 NM bm 53 10 42 am 44 71 60 pm 31 22 85 Meniscus elastic ultrasound values were measured in patients with DM and healthy volunteers under weight bearing and non-weight bearing conditions respectively. DML Lateral meniscus in a patient with type II DM,DMM Medial meniscus of a patient with type II DM,NL Lateral meniscus in a healthy volunteer,NM Medial meniscus in a healthy volunteer, bm Body of meniscus, am Anterior corner of meniscus, pm Posterior corner of meniscus In this review of 3253 knee MRI, the overall incidence of discoid meniscus was found to be 8.5%. Furthermore, it was observed that the injury rate of the medial TJ structure in the discoid meniscus group was higher compared to the control group. Specifically, type I discoid menisci were more susceptible to tears while type II discoid menisci exhibited greater stability but posed a risk for injury to the medial TJ structure. For clinicians and radiologists, type I DM is rarely overlooked regardless of symptoms, whereas type II DM may be easily disregarded due to its subjective measurement. Implementing more meticulous screening for type II DM would greatly facilitate early detection of the underlying cause of knee arthritis and enhance health education. The existing literature has demonstrated gender disparities [27,30,32], with a higher prevalence of DM observed in women, which aligns with the findings obtained from this particular sample group. The study has several limitations. Firstly, the sample size was small as it was a single-center retrospective study, which may limit its representativeness for the general population. Secondly, patients with specific medical conditions such as systemic diseases, fractures, ligament injury were excluded from this analysis; thus preventing an examination of the relationship between DM and medial structural injury in these populations. Thirdly, due to limited sample size among children participants, further analysis comparing age group differences lacked sufficient statistical power and therefore was not conducted. Conclusion Discoid meniscus is associated with a higher risk of degeneration or injury to both the meniscus and articular cartilage of the tibiofemoral joint. Specifically, Type I discoid meniscus is particularly susceptible to tears, whereas Type II discoid meniscus tends to remain intact over a broader age range but is more prone to degeneration or injury of the medial meniscus and articular cartilage. Abbreviations DM:Discoid meniscus TJ:Tibiofemoral joint MRI:Magnetic resonance imaging NDM:Nondiscoid meniscus NON-L:None of the lesions LML:Lateral meniscus lesions MML:Medial meniscus lesions LAL:Lateral articular lesions MAL:Medial articular lesions L.Total:Total lateral lesions M.Total:Total medial lesions F:Femur T:Tibia M:Medial condyle of femur L:Lateral condyle of femur m: meniscus D-m:Discoid meniscus G-Line:line of gravity SF:Line of shear force DML:Lateral meniscus in a patient with type II DM DMM:Medial meniscus of a patient with type II DM NL: Lateral meniscus in a healthy volunteer NM:Medial meniscus in a healthy volunteer bm: Body of meniscus am: Anterior corner of meniscus pm:Posterior corner of meniscus Declarations Ethics approval and consent to participate This study received approval from the Ethics Committee of the Affiliated Central Hospital of Dalian University of Technology, and all methods were conducted in strict compliance with the relevant guidelines and regulations. Informed consent from participants was also approved by the Ethics Committee of the Affiliated Central Hospital of Dalian University of Technology. The ethics committee approval number is 2025-091-01, dated March 22, 2025. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests All other authors declare no competing interests. Funding Not applicable. Authors’ contributions All authors contributed to the study conception and design. Material preparation and data collection were performed by CWQ, YHZ, ZT. YHS and PFL contributed to the design and supervision of the research. The first draft of the manuscript was written by CWQ and YHZ. YHS and PFL commented on the previous versions of the manuscript. All authors read and approved the ffnal manuscript. Acknowledgements Not applicable. This study was approved by the Ethics Committee of the Affiliated Central Hospital of Dalian University of Technology. Author details 1 Department of Radiology, The Affiliated Central Hospital of Dalian University of Technology, 826 Xuegong Street, Chunliu, Shahekou District, Dalian 116033, China 2 Department of Ultrasound, the Affiliated Central Hospital of Dalian University of Technology, 826 Xuegong Street, Chunliu, Shahekou District, Dalian 116033, China 3 Department of Orthopaedics, the Affiliated Central Hospital of Dalian University of Technology, 826 Xuegong Street, Chunliu, Shahekou District, Dalian 116033, China References Adachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R. Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear. Arthroscopy. 2004;20(5):536–42. Kim JH, Ahn JH, Kim JH, et al. Discoid lateral meniscus: importance, diagnosis, and treatment. J Exp Orthop. 2020;7:81. Qiao Y, Zhang X, Wu C, et al. 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Cite Share Download PDF Status: Published Journal Publication published 31 Jul, 2025 Read the published version in BMC Musculoskeletal Disorders → Version 1 posted Editorial decision: Revision requested 14 May, 2025 Reviews received at journal 13 May, 2025 Reviews received at journal 06 May, 2025 Reviewers agreed at journal 03 May, 2025 Reviewers agreed at journal 29 Apr, 2025 Reviewers agreed at journal 14 Apr, 2025 Reviews received at journal 08 Apr, 2025 Reviews received at journal 03 Apr, 2025 Reviewers agreed at journal 03 Apr, 2025 Reviewers agreed at journal 30 Mar, 2025 Reviewers invited by journal 24 Mar, 2025 Submission checks completed at journal 22 Mar, 2025 First submitted to journal 22 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5900364","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":433271961,"identity":"42df5d16-57a7-47b6-a3bd-fa6cb1d95d5d","order_by":0,"name":"Chengwei Qin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA50lEQVRIie3QsWoCQRCA4Q0HZzPx2hFE8wgjgZPAga8ycrDVCabbMnCwVwR7H8NHuMuB1cT6CgvTpE5Ik4Bo7CPZs7PYr56f3RmlPO8KhZ28pA+TwCQPqh2bxJ10Yc2PS9F96tiUdqLdyQCzu69bWycEEvfe7EuLj4HcrEACGKPWhsNSRcUzO3ZZ1IQmhIdlum4YtgrldeV4ZaOJBEA1WjeM74pw5kgwG39PLZ6SLJ4z1a0SosoSkEismNskpyOPnoShV9gUudTg3GVY5OX93hwnURBUnz+HZBAVi/+TP+Cycc/zPO+sX2SUTcEuf5EOAAAAAElFTkSuQmCC","orcid":"","institution":"The Affiliated Central Hospital of Dalian University of Technology","correspondingAuthor":true,"prefix":"","firstName":"Chengwei","middleName":"","lastName":"Qin","suffix":""},{"id":433271964,"identity":"af0065ae-4449-4d94-a6fe-c504b91465cf","order_by":1,"name":"Yonghua Zhang","email":"","orcid":"","institution":"The Affiliated Central Hospital of Dalian University of Technology","correspondingAuthor":false,"prefix":"","firstName":"Yonghua","middleName":"","lastName":"Zhang","suffix":""},{"id":433271966,"identity":"a53e0c64-8656-4b16-9e2d-cffa96b2cd7e","order_by":2,"name":"Zhe Tian","email":"","orcid":"","institution":"The Affiliated Central Hospital of Dalian University of Technology","correspondingAuthor":false,"prefix":"","firstName":"Zhe","middleName":"","lastName":"Tian","suffix":""},{"id":433271968,"identity":"159c4e76-435b-4c6e-9011-bd4c90a90cf5","order_by":3,"name":"Yaohua Shang","email":"","orcid":"","institution":"The Affiliated Central Hospital of Dalian University of Technology","correspondingAuthor":false,"prefix":"","firstName":"Yaohua","middleName":"","lastName":"Shang","suffix":""},{"id":433271969,"identity":"766bf7d1-f925-4418-bd3f-e2886f0ad15e","order_by":4,"name":"Pengfei Li","email":"","orcid":"","institution":"The Affiliated Central Hospital of Dalian University of Technology","correspondingAuthor":false,"prefix":"","firstName":"Pengfei","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2025-01-25 08:23:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5900364/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5900364/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12891-025-08963-8","type":"published","date":"2025-07-31T16:21:04+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":79321924,"identity":"41f33928-4ad1-4c49-bc05-610914f569af","added_by":"auto","created_at":"2025-03-27 04:37:04","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":42041,"visible":true,"origin":"","legend":"\u003cp\u003eThe flow diagram of patient enrollment.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5900364/v1/501a0f8de7006c5b0ea28962.jpg"},{"id":79323698,"identity":"136c7543-6418-4181-8259-a90bddea5251","added_by":"auto","created_at":"2025-03-27 05:01:05","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":168687,"visible":true,"origin":"","legend":"\u003cp\u003e2a\u003c/p\u003e\n\u003cp\u003eAssuming that the tibial plateau is parallel to the horizontal line, the long axis of the femur is parallel to the gravity line, the inner and outer condyles of the femur are equal spheres, and the inner and outer meniscus are equal in thickness, then ∠α=∠β=90°\u003c/p\u003e\n\u003cp\u003e2.b\u003c/p\u003e\n\u003cp\u003eThe DM elevates the lateral condyle of the femur, causing the long axis of the femur to tilt, and ∠β \u0026lt; 90°, then gravity generates a component force SF in the direction of the femur tilt.\u003c/p\u003e\n\u003cp\u003eF femur ,T tibia ,M medial condyle of femur ,L lateral condyle of femur, m meniscus ,D-m Discoid meniscus (red areas represent excrescent parts) ,G-Line line of gravity , ∠αthe Angle where the gravity line intersects the horizontal line，∠β The Angle where the gravity line intersects the central line of the medial condyle and lateral condyle of the femur ,SF Line of shear force.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5900364/v1/0219e1842475d779479d7314.png"},{"id":79321926,"identity":"e2aa0d23-2b59-4d65-9fbd-c3214bec8304","added_by":"auto","created_at":"2025-03-27 04:37:04","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":15168,"visible":true,"origin":"","legend":"\u003cp\u003eA vague high signal was seen in the medial meniscus body or posterior corner at the junction of the joint capsule in MR imaging with DM(especially type II DM which is often intact), that's a shear strain caused by shear force SF as shown (arrow).\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5900364/v1/ab19c1a82fd1865dfc2b89bd.jpg"},{"id":79323120,"identity":"eae62865-882d-4e30-80b6-e0a4987fb1ab","added_by":"auto","created_at":"2025-03-27 04:53:05","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":38790,"visible":true,"origin":"","legend":"\u003cp\u003eA Canon Aplio i9oo ultrasound workstation is performed by a musculoskeletal radiologist to measure the meniscus elastic ultrasound values.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5900364/v1/b0dc3567a8a660b2e23d1493.png"},{"id":79321936,"identity":"5870d679-9101-4f37-b2d2-36c5b3f87ca6","added_by":"auto","created_at":"2025-03-27 04:37:05","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":42478,"visible":true,"origin":"","legend":"\u003cp\u003eMeniscus elastic ultrasound values were measured Under non-load bearing conditions.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-5900364/v1/7f996f88414dfd770c34d0fc.png"},{"id":79321928,"identity":"72a27ca9-f67e-4c0c-8662-eb880e0f9998","added_by":"auto","created_at":"2025-03-27 04:37:05","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":41292,"visible":true,"origin":"","legend":"\u003cp\u003eMeniscus elastic ultrasound values were measured Under weight-bearing conditions.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-5900364/v1/49174a65ea85ed49a2792abb.png"},{"id":88268170,"identity":"586b5430-ac55-4c04-ab9d-0614eb6d567c","added_by":"auto","created_at":"2025-08-04 16:49:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":742875,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5900364/v1/e468c7d5-86ee-4ebf-a32e-500d21d29373.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and Correlation Analysis of Lateral Discoid Meniscus with Degeneration or Injury of the Meniscus and Articular Cartilage in the Entire Tibiofemoral Joint","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDiscoid meniscus (DM) is a congenital morphological anomaly predominantly affecting the lateral meniscus [\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], first documented in 1889 by Young through cadaver dissection [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Its prevalence is notably higher in Asian populations (10\u0026ndash;15%) compared to Western populations (3\u0026ndash;5%) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Due to its atypical shape and structure, the disc-shaped meniscus is more susceptible to injury. Moreover, the presence of a discoid meniscus disrupts the balance of the knee joint, leading to uneven force distribution across the tibiofemoral joint(TJ) surface. This inevitably influences physiological and pathological changes in the entire TJ, particularly affecting the medial and lateral menisci as well as the articular cartilage, thereby causing adverse effects. To the best of our knowledge, there is insufficient research analyzing the impact of discoid menisci on the TJ as a whole, with specific emphasis on the medial TJ. Therefore, this study aims to investigate the incidence of various types of discoid menisci and their potential effects on the overall TJ surface using magnetic resonance imaging (MRI). Moreover, injury rates differ between type I and type II discoid menisci due to variations in their histological structure and morphology [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. This may result in TJ injuries in other areas before the DM itself is damaged, a condition that is often overlooked by sports medicine practitioners. This study screened 3,253 patients who underwent MRI scanning in the outpatient department of our hospital. The prevalence of DM among these patients was 8.5%, and TJ injury was analyzed in a cohort with a mean age of 40.3 years (range, 8\u0026ndash;73 years).\u003c/p\u003e"},{"header":"Methods","content":" \u003cp\u003e Study population:This retrospective study was approved by our institution's review board. From December 2023 to November 2024, 3253 patients undergoing knee MRI examinations at our outpatient clinic were screened. Patients with a lateral discoid meniscus were included in the DM group. For a sex- and age-matched non-discoid meniscus (NDM) group, patients were selected from the remaining subjects, excluding those with syndromic diagnoses such as Marfan syndrome, Ehlers-Danlos syndrome, etc., autoimmune diseases (e.g., rheumatoid arthritis), metabolic diseases (e.g., gout), cerebral palsy, joint hypermobility syndrome, fractures, ligament injuries, or prior knee surgeries.\u003c/p\u003e \u003cp\u003eMRI examination and measurement: All patients were examined using the same imaging modality (GE Signa Pioneer, 3.0-T, slice thickness: 3.0 mm). The images were reviewed by two musculoskeletal (MSK) radiologists to define the injury types of the meniscus and articular cartilage. In cases of discrepancy, a secondary independent review was conducted by the original reviewers, followed by resolution through majority vote by a five-member panel consisting of two sports medicine surgeons and three MSK radiologists.\u003c/p\u003e \u003cp\u003eDiscoid meniscus: The type of DM was classified on the coronal and sagittal planes of MRI using the Watanabe classification. DM is diagnosed if any of the following conditions are met: (1) the minimum width of the midsegment of the meniscus on the coronal slice is \u0026ge;\u0026thinsp;15 mm; (2) the ratio of the minimum meniscal width to the maximum tibial plateau width on the coronal slice is \u0026ge;\u0026thinsp;20%; (3) the ratio of the combined width of the anterior and posterior horns to the maximal meniscal diameter on the sagittal slice displaying the largest meniscal diameter is \u0026ge;\u0026thinsp;75%. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eMeniscus and Joint Cartilage Injury: The Stollar classification system is used to grade meniscus injuries. Grade 0: A normal meniscus, characterized by a homogeneous low signal intensity and regular morphology. Grade I: Intra-meniscal punctate or speckled high-signal areas are observed, but do not connect to the joint surface. Grade II: Linear high-signal areas are present within the meniscus, extending to the meniscus-capsule junction, but not reaching the articular surface. Grade III: High-signal areas within the meniscus extend to the articular surface, indicating various types of meniscus tears, meniscus-capsule detachment, and meniscus cysts. When multiple signals are present, only the highest-grade signal is recorded. The Hepple classification system is used for grading cartilage injuries. Grade 1: Isolated joint cartilage injury. Grade 2: Joint cartilage injury with an associated subchondral fracture, regardless of the presence or absence of surrounding bone marrow edema. Grade 3: Separated bone fragments that are not displaced. Grade 4: Separated and displaced bone fragments. Grade 5: Formation of subchondral cysts within the joint cartilage. When multiple signals are present, only the highest-grade signal is recorded. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eStatistical analysis: Statistical analyses were conducted using SPSS version 26.0. The Kolmogorov-Smirnov test was employed to assess the normality of the data. For normally distributed data, ANOVA was utilized; for non-normally distributed data, the independent samples Kruskal-Wallis test and Mann-Whitney U test were applied. The Chi-square test was used to examine the association between DM and TJ injury When required, Fisher's exact test and Bonferroni correction were performed, with a significance level set at 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 3253 patients were screened, and 278 were included in the DM group, corresponding to an incidence rate of 8.5%. An additional 279 patients were matched by sex and age to form the NDM group. The inclusion criteria and the number of patients are summarized in Figure 1.\u003c/p\u003e\n\u003cp\u003eTable 1 provides the baseline characteristics of both groups. The frequency and distribution of injuries in the two groups are detailed in Table 2. The overall incidence of injuries was significantly higher in the DM group compared to the NDM group (P \u0026lt; 0.05). Specifically, the DM group exhibited a significantly higher percentage of medial tibiofemoral articular cartilage and meniscus injuries compared to the NDM group (P \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003eTable 1 Descriptive Statistics for Patient Demographics\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eVariables\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eNon-Discoid Meniscus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003eDiscoid Meniscus\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003ePatients, n\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAge, median (range)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSex\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale, n (%)\u003c/p\u003e\n \u003cp\u003eMale, n (%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eSide\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLeft, n (%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; Right, n (%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e279\u003c/p\u003e\n \u003cp\u003e40 (8\u0026ndash;71)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e153 (55%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e126 (45%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e144(52%)\u003c/p\u003e\n \u003cp\u003e135(48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33.3333%;\"\u003e\n \u003cp\u003e278\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41 (9\u0026ndash;73)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e150(54%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e128 (46%)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e142 (51%)\u003c/p\u003e\n \u003cp\u003e136 (49%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;A total of 279 patients were enrolled in the sex- and age- matched NDM group.\u003c/p\u003e\n\u003cp\u003eTable2 The incidence of meniscus and articular cartilage degeneration or injury in the DM and NDM groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"584\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 11.5318%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.3924%;\"\u003e\n \u003cp\u003eNON-L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.7367%;\"\u003e\n \u003cp\u003eLML\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003eMML\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8761%;\"\u003e\n \u003cp\u003eLAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003eMAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003eL.Total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3184%;\"\u003e\n \u003cp\u003eM.Total\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9.29432%;\"\u003e\n \u003cp\u003eDM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 14.6299%;\"\u003e\n \u003cp\u003e47(17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.7367%;\"\u003e\n \u003cp\u003e88(32%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003e94(34%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8761%;\"\u003e\n \u003cp\u003e5(2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003e44(16%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003e93(26%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3184%;\"\u003e\n \u003cp\u003e138 (34%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 9.29432%;\"\u003e\n \u003cp\u003eNDM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 14.6299%;\"\u003e\n \u003cp\u003e180(65%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.7367%;\"\u003e\n \u003cp\u003e29 (10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003e31(11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11.8761%;\"\u003e\n \u003cp\u003e18(6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003e21(8%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.0482%;\"\u003e\n \u003cp\u003e47(17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.3184%;\"\u003e\n \u003cp\u003e52(19%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe highest level of degeneration or injury of articular cartilage and meniscus of medial and lateral TJ was counted in the DM and NDM groups .\u003c/p\u003e\n\u003cp\u003eNON-L none of the lesions,LML lateral meniscus lesions,MML medial meniscus lesions,LAL lateral articular lesions,MAL medial articular lesions,L.Total total lateral lesions,M.Total total medial lesions\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong the DM group, there were 93 cases of type I DM and 185 cases of type II DM, with no cases of type III DM. The number and proportion of injuries at different anatomical positions in each DM group are presented in Table 3. The overall incidence of TJ injury did not differ significantly between the two groups (P = 0.971). However, the proportion of medial tibiofemoral joint injuries was significantly higher in the type II DM group compared to the type I DM group (P \u0026lt; 0.001). Additionally, the incidence of lateral meniscus injury was significantly higher in the type I DM group compared to the type II DM group (P \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003eTable3 The incidence of meniscus and articular cartilage degeneration or injury in each type of DM group\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 12.234%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003eNON-L\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003eLML\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003eMML\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.234%;\"\u003e\n \u003cp\u003eLAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003eMAL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003eL.Total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003eM.Total\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 12.234%;\"\u003e\n \u003cp\u003eTypeⅠDM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e12(13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e58(63%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e11(12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.234%;\"\u003e\n \u003cp\u003e3(3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e9(10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e61(66%) \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e20 (22%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 12.234%;\"\u003e\n \u003cp\u003eTypeⅡDM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e35(19%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e30(16%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e83(45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.234%;\"\u003e\n \u003cp\u003e\u0026nbsp;2(1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e35(19%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e32(17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.5887%;\"\u003e\n \u003cp\u003e118(64%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe highest level of degeneration or injury of articular cartilage and meniscus of medial and lateral TJ was counted in the TypeⅠDM and TypeⅡDM groups .\u003c/p\u003e\n\u003cp\u003eNON-L none of the lesions,LML lateral meniscus lesions,MML medial meniscus lesions,LAL lateral articular lesions,MAL medial articular lesions, L.Total total lateral lesions,M.Total total medial lesions\u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eDiscoid meniscus (DM) was initially reported by Young in 1889 during cadaver dissection[8]. It is commonly observed, with an approximate incidence rate ranging from 0.4% to 17%. However, discoid medial meniscus is seldom detected, with an incidence of 0.06% to 0.3%. A higher prevalence has been noted in Asian populations (10\u0026ndash;15%) compared to Western populations (3\u0026ndash;5%). Bilateral involvement is witnessed in 15\u0026ndash;25% of the patients with DM. [1,3,5,9,11, 12,13,18,23,28,32]\u003c/p\u003e\n\u003cp\u003eThe diagnosis and treatment of DM have been extensively discussed in the literature. However, there is a dearth of comprehensive studies on its impact on the entire TJ. In the early stages, DM often remains asymptomatic, particularly in type II DM, whose symptoms are more subtle.Nevertheless, long-term biomechanical abnormalities can give rise to damage in both lateral and medial structures of the TJ during movement. [2, 4, 6, 17,19,25]\u003c/p\u003e\n\u003cp\u003eTo facilitate calculations, simplify the knee joint into a geometric figure \u0026nbsp; (Fig.2)，assuming that the internal and external condyles of the femur are equal in size spherically, while the tibial plateau remains parallel to the horizontal line，additionally assuming that the gravity line and lower limb force line is perpendicular to the horizontal line. The disc-shaped meniscus elevates the lateral condyle of femur and increases lateral TJ space, causing additional shear forces on the medial component which often results in strain on synovial edge (Fig.3). At the same time，with an inward tilt of gravity line, stress per unit area increases on medial tibial plateau while it decreases on lateral plateau, the medial and lateral articular cartilage and meniscus of TJ will be subjected to this pressure change. Relying on simple mechanical principles, we can get the above results.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFurthermore, authors have identified variations in the histologic structure between type I and type II DM [15], suggesting potential differences in their strength and hardness. This discrepancy may explain the increased susceptibility of type I DM to tearing, while type II DM tends to demonstrate greater durability over extended periods. These findings align with empirical observations indicating that acute tears frequently occur in type I DM, whereas chronic damage to the medial structure is commonly associated with type II DM. This suggests that under an imbalanced pressure environment, the lateral type II DM exhibits resistance to pressure, while the medial synovial edge experiences strain due to compression and shear forces. [14,16,26,27,31]\u003c/p\u003e\n\u003cp\u003eTo validate the impact of the DM on \u0026nbsp;dynamics TJ, we devised an experiment comprising a series of elastosonography assessments conducted on the static knee meniscus ,the knee positions include the no-load position, weight-bearing kneeling position, and weight-bearing knee extension position(Fig.4-6). The meniscus hardness was assessed using elastosonography in both a healthy volunteer and a patient with type 2 disk meniscus. Our findings revealed variations in meniscus hardness between the two subjects. There was no significant difference in the hardness of the medial and lateral meniscus in the healthy volunteer. However, during load-bearing kneeling positions,the patient with type II DM exhibited greater hardness in the medial meniscus compared to the lateral meniscus. Notably, maximum hardness was observed in the posterior corner of the medial meniscus during load-bearing kneeling positions for type II DM patients（Table4）. The findings of this experiment suggest that type II DM leads to biomechanical abnormalities within the knee joint, specifically resulting in the transmission of pressure towards the posterior corner of the medial meniscus.\u003c/p\u003e\n\u003cp\u003eTable4 Meniscus elastic ultrasound measurements (kpa) in a healthy volunteer and a patient with type II DM\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eElastic ultrasonic measurement（kPa）of meniscus\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eNo-load test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eStraighten knee in gravity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003eBending knee in gravity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eDML\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003ebm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003epm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eDMM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003ebm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003epm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eNL\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003ebm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003epm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eNM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003ebm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003epm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 111px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMeniscus elastic ultrasound values were measured in patients with DM and healthy volunteers under weight bearing and non-weight bearing conditions respectively.\u003c/p\u003e\n\u003cp\u003eDML Lateral meniscus in a patient with type II DM,DMM Medial meniscus of a patient with type II DM,NL Lateral meniscus in a healthy volunteer,NM Medial meniscus in a healthy volunteer, bm Body of meniscus, am Anterior corner of meniscus, pm Posterior corner of meniscus\u003c/p\u003e\n\u003cp\u003eIn this review of 3253 knee MRI, the overall incidence of discoid meniscus was found to be 8.5%. Furthermore, it was observed that the injury rate of the medial TJ structure in the discoid meniscus group was higher compared to the control group. Specifically, type I discoid menisci were more susceptible to tears while type II discoid menisci exhibited greater stability but \u0026nbsp;posed a risk for injury to the medial TJ structure.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFor clinicians and radiologists, type I DM is rarely overlooked regardless of symptoms, whereas type II DM may be easily disregarded due to its subjective measurement. Implementing more meticulous screening for type II DM would greatly facilitate early detection of the underlying cause of knee arthritis and enhance health education.\u003c/p\u003e\n\u003cp\u003eThe existing literature has demonstrated gender disparities [27,30,32], with a higher prevalence of DM observed in women, which aligns with the findings obtained from this particular sample group.\u003c/p\u003e\n\u003cp\u003eThe study has several limitations. Firstly, the sample size was small as it was a single-center retrospective study, which may limit its representativeness for the general population. Secondly, patients with specific medical conditions such as systemic diseases, fractures, \u0026nbsp;ligament injury were excluded from this analysis; thus preventing an examination of the relationship between DM and medial structural injury in these populations. Thirdly, due to limited sample size among children participants, further analysis comparing age group differences lacked sufficient statistical power and therefore was not conducted.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eDiscoid meniscus is associated with a higher risk of degeneration or injury to both the meniscus and articular cartilage of the tibiofemoral joint. Specifically, Type \u0026nbsp;I discoid meniscus is particularly susceptible to tears, whereas Type \u0026nbsp;II discoid meniscus tends to remain intact over a broader age range but is more prone to degeneration or injury of the medial meniscus and articular cartilage.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eDM:Discoid meniscus\u003c/p\u003e\n\u003cp\u003eTJ:Tibiofemoral joint\u003c/p\u003e\n\u003cp\u003eMRI:Magnetic resonance imaging\u003c/p\u003e\n\u003cp\u003eNDM:Nondiscoid meniscus\u003c/p\u003e\n\u003cp\u003eNON-L:None of the lesions\u003c/p\u003e\n\u003cp\u003eLML:Lateral meniscus lesions\u003c/p\u003e\n\u003cp\u003eMML:Medial meniscus lesions\u003c/p\u003e\n\u003cp\u003eLAL:Lateral articular lesions\u003c/p\u003e\n\u003cp\u003eMAL:Medial articular lesions\u003c/p\u003e\n\u003cp\u003eL.Total:Total lateral lesions\u003c/p\u003e\n\u003cp\u003eM.Total:Total medial lesions\u003c/p\u003e\n\u003cp\u003eF:Femur\u003c/p\u003e\n\u003cp\u003eT:Tibia\u003c/p\u003e\n\u003cp\u003eM:Medial condyle of femur\u003c/p\u003e\n\u003cp\u003eL:Lateral condyle of femur\u003c/p\u003e\n\u003cp\u003em: meniscus\u003c/p\u003e\n\u003cp\u003eD-m:Discoid meniscus\u003c/p\u003e\n\u003cp\u003eG-Line:line of gravity\u003c/p\u003e\n\u003cp\u003eSF:Line of shear force\u003c/p\u003e\n\u003cp\u003eDML:Lateral meniscus in a patient with type II DM\u003c/p\u003e\n\u003cp\u003eDMM:Medial meniscus of a patient with type II DM\u003c/p\u003e\n\u003cp\u003eNL: Lateral meniscus in a healthy volunteer\u003c/p\u003e\n\u003cp\u003eNM:Medial meniscus in a healthy volunteer\u003c/p\u003e\n\u003cp\u003ebm: Body of meniscus\u003c/p\u003e\n\u003cp\u003eam: Anterior corner of meniscus\u003c/p\u003e\n\u003cp\u003epm:Posterior corner of meniscus\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThis study received approval from the Ethics Committee of the Affiliated Central Hospital of Dalian University of Technology, and all methods were conducted in strict compliance with the relevant guidelines and regulations. Informed consent from participants was also approved by the Ethics Committee of the Affiliated Central Hospital of Dalian University of Technology. The ethics committee approval number is 2025-091-01, dated March 22, 2025.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eAll other authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAuthors’ contributions All authors contributed to the study conception and design. Material preparation and data collection were performed by CWQ, YHZ, ZT. YHS and PFL contributed to the design and supervision of the research. The first draft of the manuscript was written by CWQ and YHZ. YHS and PFL commented on the previous versions of the manuscript. All authors read and approved the ffnal manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Ethics Committee of the Affiliated Central Hospital of Dalian University of Technology.\u003c/p\u003e\n\u003cp\u003eAuthor details\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1 Department of Radiology, The Affiliated Central Hospital of Dalian University of Technology, \u0026nbsp;826 Xuegong Street, Chunliu, Shahekou District, Dalian 116033, China\u003c/p\u003e\n\u003cp\u003e2 Department of Ultrasound, the Affiliated Central Hospital of Dalian University of Technology, 826 Xuegong Street, Chunliu, Shahekou District, Dalian 116033, China\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e3 Department of Orthopaedics, the Affiliated Central Hospital of Dalian University of Technology, 826 Xuegong Street, Chunliu, Shahekou District, Dalian 116033, China\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAdachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R. 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Radiol Clin North Am. 2009;47(4):703\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNobuhiko Samotoa MK, Tokuhisab T, Kobayashib K. Diagnosis of discoid lateral meniscus of the knee on MR imaging. Magn Reson Imaging. 2002;20:59\u0026ndash;64.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAraki Y, Yamamoto H, Nakamura H, Tsukaguchi I. MR diagnosis of discoid lateral menisci of the knee. Eur J Radiol. 1994;18:92\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim J-H. Jin hwan Ahn,Joo-Hwan Kim,Joon Ho Wang.Discoid lateral meniscus: importance, diagnosis, and treatment. J Experimental Othopaedics. 2020;10:7\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAcebes C, Roman-Blas JA, Delgado-Baeza E, Palacios I, Herrero-Beaumont G. Correlation between arthroscopic and histopathological grading systems of articular cartilage lesions in knee osteoarthritis. Osteoarthritis Cartilage. 2009;17(2):205\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIlyas G, Burak F. Validity of Hepple Classification Used in the Diagnosis of Talus Osteochondral Lesions. J Am Podiatr Med Assoc. 2023 Sep;1:1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLaurent T, Meuli R, Landry M, Leyvraz PF. Corr\u0026eacute;lation entre arthroscopie et IRM dans le diagnostic des d\u0026eacute;chirures m\u0026eacute;niscales du genou [Correlation between arthroscopy and MRI in the diagnosis of meniscal tears of the knee]. Praxis (Bern 1994). 1995;84(12):335\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReicher MA, Hartzman S, Duckwiler GR, Bassett LW, Anderson LJ, Gold RH. Meniscal injuries: detection using MR imaging. Radiology. 1986;159(3):753\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Discoid meniscus, Degeneration, Prevalence, Congenital malformation","lastPublishedDoi":"10.21203/rs.3.rs-5900364/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5900364/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground\u003c/p\u003e\n\u003cp\u003eThe current discussion comprehensively addresses the injury and treatment of discoid meniscus (DM). However, it is important to note that an unfavorable biomechanical environment caused by DM not only leads to self-injury but also has a significant impact on adjacent structures. Therefore, the aim of this study was to investigate the relationship between DM and injuries in both the meniscus and cartilage within the total tibiofemoral joint(TJ).\u003c/p\u003e\n\u003cp\u003eMethods\u003c/p\u003e\n\u003cp\u003ePatients undergoing knee magnetic resonance imaging (MRI) examinations at our outpatient clinic were screened, and a total of 278 patients were enrolled in the DM group, with 279 patients in the non-discoid meniscus (NDM) group. The type of DM was classified according to the Watanabe classification, while meniscal and articular cartilage injuries were classified using the Stoller and Hepple classifications, respectively. The prevalence of DM and injuries to the meniscus and articular structures within the TJ in the general population was assessed, along with their relationship.\u003c/p\u003e\n\u003cp\u003eResults\u003c/p\u003e\n\u003cp\u003eThe prevalence of DM was 8.5%, while the incidence of TJ injury was 10%. Notably, the DM group exhibited a significantly higher incidence of TJ injury (P \u0026lt;0.001). Among the cases, there were 93 patients with type I DM and 185 patients with type II DM. Specifically, the type I DM group showed a significantly higher percentage of lateral meniscus injuries (P \u0026lt;0.005), whereas the type II DM group demonstrated a significantly higher percentage of medial TJ injuries (P \u0026lt;0.005).\u003c/p\u003e\n\u003cp\u003eConclusion\u003c/p\u003e\n\u003cp\u003eDiscoid meniscus is associated with a higher risk of degeneration or injury to both the meniscus and articular cartilage of the tibiofemoral joint. Specifically, Type I discoid meniscus is particularly susceptible to tears, whereas Type II discoid meniscus tends to remain intact over a broader age range but is more prone to degeneration or injury of the medial meniscus and articular cartilage.\u003c/p\u003e\n\u003cp\u003eStudy design\u003c/p\u003e\n\u003cp\u003eRetrospective study.\u003c/p\u003e","manuscriptTitle":"Prevalence and Correlation Analysis of Lateral Discoid Meniscus with Degeneration or Injury of the Meniscus and Articular Cartilage in the Entire Tibiofemoral Joint","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-27 04:37:00","doi":"10.21203/rs.3.rs-5900364/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-05-14T14:36:20+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-13T21:50:08+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-06T11:24:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"338550214238804669193393700847948938684","date":"2025-05-03T20:00:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"83640494261638562993975820403647322949","date":"2025-04-29T19:08:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263740867472655019335801759346115075404","date":"2025-04-14T17:56:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-08T15:23:49+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-03T08:28:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"110795089696153472761860093411982233516","date":"2025-04-03T04:19:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"106041919356508491403212253836601875945","date":"2025-03-30T09:53:03+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-24T10:35:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-22T15:22:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Musculoskeletal Disorders","date":"2025-03-22T15:21:34+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"32bfa211-2c30-4256-85fd-bfd2a20c9863","owner":[],"postedDate":"March 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-08-04T16:40:53+00:00","versionOfRecord":{"articleIdentity":"rs-5900364","link":"https://doi.org/10.1186/s12891-025-08963-8","journal":{"identity":"bmc-musculoskeletal-disorders","isVorOnly":false,"title":"BMC Musculoskeletal Disorders"},"publishedOn":"2025-07-31 16:21:04","publishedOnDateReadable":"July 31st, 2025"},"versionCreatedAt":"2025-03-27 04:37:00","video":"","vorDoi":"10.1186/s12891-025-08963-8","vorDoiUrl":"https://doi.org/10.1186/s12891-025-08963-8","workflowStages":[]},"version":"v1","identity":"rs-5900364","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5900364","identity":"rs-5900364","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}