Characteristic morphology of the proximal tibiofibular joint in patients with discoid lateral meniscus.

Abstract

Patients with discoid lateral meniscus (DLM) are prone to meniscal injuries related to its shape and abnormal mobility. The anatomical joint inclination of the proximal tibiofibular joint (PTFJ) can also affect joint movement in knee motion. However, an association between PTFJ morphology and DLM remains unclear. The purpose of this study was to investigate the morphology of the PTFJ on MRI and how this differs between patients with and without DLM. Fifty-eight patients with DLM and 58 age-matched controls (normal meniscus) were included in this study. Slices from preoperative MRI sagittal images that clearly showed the PTFJ were used for measurements. The angle between the PTFJ and the perpendicular line of the fibula axis was measured as the inclination angle, and patients were classified as horizontal-type (<20°) or oblique-type (>20°). The inclination angle was also compared among patients with open and closed epiphysis in both groups to assess the effect of age. Patients in the horizontal-type PTFJ group frequently had DLM. Before epiphyseal closure, most patients had a horizontal-type PTFJ, with or without DLM. However, in older patients with a closed epiphysis, most with a normal meniscus had an oblique-type PTFJ, and those with DLM retained the horizontal-type joint. The horizontal-type PTFJ was significantly associated with DLM, and patients with DLM tended to retain a horizontal-type PTFJ after epiphyseal closure. In contrast, in patients with a normal meniscus, the PTFJ may change from a horizontal-type to an oblique-type PTFJ in line with bone maturity.