Discoid meniscus is a congenital abnormality where the meniscus is larger and disc-shaped rather than crescent shaped. It occurs in 3-5% of the population and more commonly affects the lateral meniscus. Discoid meniscus has less vascularization and lower collagen density, making it more prone to tearing. While often asymptomatic, it can cause knee pain, locking, and limitation of activity. MRI is used to confirm the diagnosis and assess for tears. Treatment involves surgery if symptomatic, with the goal of preserving as much meniscal tissue as possible through techniques like saucerization or subtotal meniscectomy.
Discoid meniscus is a congenital abnormality of the lateral compartment of the knee and not only a big meniscus
The leading cause of non traumatic snapping and extension deficit in children and adolescents
Clinical examination is more sensitive and specific for diagnosis
MRI is a good tool for diagnosis
Meniscal preserving surgeries are recommended to avoid degenerative arthritis
Long-term follow-up studies are needed to determine the effects of meniscal Saucerization and repair on the risk of OA.
Discoid meniscus is a congenital abnormality of the lateral compartment of the knee and not only a big meniscus
The leading cause of non traumatic snapping and extension deficit in children and adolescents
Clinical examination is more sensitive and specific for diagnosis
MRI is a good tool for diagnosis
Meniscal preserving surgeries are recommended to avoid degenerative arthritis
Long-term follow-up studies are needed to determine the effects of meniscal Saucerization and repair on the risk of OA.
muscle pedicle grafting for delayed presentation of intra cpasular fracture neck of Femur.. a study of 65 cases in Osmania Medical College, Hyderabad, Telengana.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
muscle pedicle grafting for delayed presentation of intra cpasular fracture neck of Femur.. a study of 65 cases in Osmania Medical College, Hyderabad, Telengana.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Meniscal injuries and physiotherapy managementSyed Adil
meniscal tear
Anatomy
Types of meniscal tear
Etiology
Clinical features including (special tests)
Differential diagnosis
Management for partial meniscal tear and full meniscal tear, meniscectomy
Recent advance
for meniscal tears
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The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
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Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
2. ANATOMY
MEDIAL MENISCUS
• C – shaped structure
• Most of the weight is borne by
posterior part of meniscus
LATERAL MENISCUS
• Semicircular
• More mobile than medial
meniscus
4. EMBRYOLOGY
• The menisci differentiate from the mesenchymal tissue in the 8th week of
gestation, and by week 14 they have their mature anatomical form.
• Kaplan, did not identify discoid menisci as a stage during development and
was the first to propose that the discoid form is due to a deficit in the
posterior meniscofemoral fixation (Wrisberg).Although Kaplan’s theory
does not explain the existence of discoid menisci with normal posterior
femoral fixation, it is established that there is a synergy between discoid
shape and instability.
• The meniscus is completely vascularized at birth, with progressive decline
until age 10 years, at which point only the most peripheral third of the
meniscus is vascularized.Discoid menisci have less vascularization in the
periphery than those with normal shape.
5. ULTRASTRUCTURE
• Lower collagen density
• Disorganized network that predisposes it to breakage
• Histologically, the discoid meniscus presents mucinous alterations,
similar to those found in degenerative menisci
• Thicker meniscus
• Increased surface area
6. DISCOID MENISCUS
Abnormal development of meniscus leads to a hypertrophic and
discoid shaped meniscus.
Discoid meniscus is usually larger than normal
Disc shaped
7. EPIDEMIOLOGY
Incidence:
Seen in 3-5% of population
Predilection:
Lateral meniscus is involved more frequently than medial
25% cases are bilateral
9. PRESENTATION
• Usually asymptomatic unless they are unstable or torn
• Pain is most common
• Mechanical Clicking and locking
• Abnormal gait
On Examination
• Lateral joint line pain
• Extension lag
• Clunk
• Positive meniscal tests
10.
11. RADIOLOGY
Radiographs of knee joint AP and lateral views
• Widened joint space
• Squaring of lateral femoral condyle
• Cupping of lateral tibia plateau
• hypoplastic intercondylar spine
12. MRI
• Confirming the diagnosis and preoperative planning
• Characterization of the meniscal shape, associated tears, stability, and
concomitant injuries
Discoid meniscus
• Transverse diameter >15mm in coronal view
• Continuity between anterior and posterior horns in three consecutive
saggital cuts
• Ratio of minimal meniscus width to maximal tibial width >20%
(sensitive and specific) BOW-TIE Sign
13.
14. MRI
Lateral discoid meniscus with a
concomitant horizontal tear.
Complete discoid meniscus with
intrasubstance degenerative
changes
15. MANAGEMENT
• Most patients are asymptomatic, since the knee eventually adapts to
the anatomy, maintaining good function.
• Asymptomatic discoid meniscus without any tear – Observation and
conservative management.
• Might get tear in near future so regular follow ups are required
16. • Surgical treatment is recommended where there are persistent
symptoms, such as pain, locking or limitation of sports activities.
• Given the known importance of the meniscus to knee function, and
the fact that its absence triggers early degenerative changes,
attempts to preserve the structure are an absolute priority
17. Surgical management
• Tears of complete or incomplete
discoid menisci
• cause pain, popping, and snapping
within the knee and that
• show a hypermobile medial
segment but intact peripheral
• attachments are best treated by
subtotal meniscectomy
• Saucerization of the mobile
fragment
18. • Wrisberg-type discoid meniscus
• lacks an adequate posterior
tibial attachment
• Total meniscectomy, either open
or arthroscopic
• subtotal meniscectomy alone
leaves an unstable rim of
meniscus that is certain to cause
future problems
19. Rehabilitation
• Isolated discoid meniscus: Post
Saucerization is to allow immediate
total weight-bearing.
• Physical therapy is started after
two weeks, with gradual return to
sports after eight weeks.
• Meniscal repair:
Partial weight-bearing with crutches,
and a hinged brace with range of
movement limited from 0º to 30º for
the first six weeks.
Full weight-bearing and progressive
free range of movement is allowed
at six weeks postoperatively.
Physical therapy begins after two
weeks postoperatively and return to
sports depends on the patient’s
movement and strength recovery,
usually after 12 week
