Evangeline Singh, K (2020) Radiological and Cadaveric Study of Medial and Lateral Menisci of Knee Joint in Adult and Fetus in South Indian Population. Masters thesis, PSG Institute of Medical Sciences and Research, Coimbatore.
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Abstract
INTRODUCTION: The Latin word ´Menisciۥ stems from a Greek word ῝meniskos” which denotes crescent. These intracapsular fibro cartilaginous structures are termed so because of their peculiar crescent moon like appearance. The shape of menisci could be discoid and non-discoid menisci(Young et al 1889)and the discoid menisci could be sub classified as complete and incomplete discoid menisci (Watanabe et al 1979). The non discoid menisci has variants like sickle shaped, sided U shaped, sided V shaped, crescentic (semi lunar)shaped and C shaped(Kale et al 2006).The incidence of discoid menisci is estimated to be 0.4% to 17%. The discoid menisci was first observed in a cadaveric specimen by Young(1889). Meniscal tears are the most common among knee injuries. Previous studies reported an annual incidence of 61 per 100,000 people(Baker et al,1985). A mismatch in the size of more than 10% disturbs the contact mechanics and also increase the internal meniscus loads (Dienst [et. al.], 2007). A finite element analysis reported that the articular cartilage is more sensitive to geometric changes in the medial meniscus than the lateral meniscus due to its greater contact Ares(Donahue [et. al.], 2004). This study targeted to enrich the anatomical knowledge on the incidence of morphological variations and morphometric data of menisci in dissected cadaveric fetal and adult specimens and MRI Images in this current geographic locale-Tamilnadu, India which will provide a greater insight in designing size matched meniscal scaffolds. AIM AND OBJECTIVE : To study the incidence of morphological variations and to characterize and present midrange values and variability of knee menisci in dissected adult cadaveric specimens, dissected fetal cadaveric specimens and Magnetic Resonance Imaging. MATERIALS AND METHODS: The sample size of 250 which included 100 formalin preserved fetal knee menisci,50 formalin preserved adult knee menisci from Department of Anatomy, PSGIMS&R .The knee joint with bony abnormalities such as exostosis, fracture and arthritic knee were excluded from our study and 100 MRI Images of knee menisci from the Department of Radio diagnosis, PSGIMS&R.MRI with meniscal tears and bony anomalies were excluded from our study. RESULTS AND ANALYSIS: Among 50 adult cadaveric lateral menisci, C shaped menisci had the highest incidence of 58% and the variant with lowest incidence was incomplete discoid menisci (2%) and among medial menisci, Crescent shaped menisci had the highest incidence accounting to 74% and C shaped menisci (4%) had the lowest incidence. Among 100 fetal cadaveric lateral menisci, C shaped menisci (66%) had the highest incidence and ring shaped menisci (1%) had the lowest incidence and amongst cadaveric fetal medial menisci, crescent shaped (52%) had the highest incidence and U shaped menisci(4%) had the lowest incidence. The mean thickness and width of adult cadaveric menisci was statistically significantly lower than the mean thickness and width of MRI adult menisci. The mean thickness of fetal cadaveric medial menisci at anterior third was 0.71±0.34mm, middle third was 0.77±0.58mm, posterior third was 0.58±0.66mm and the mean width of fetal cadaveric medial menisci at anterior third was 2.94±0.61mm, middle third was 2.88±0.61mm and posterior third was 3.28±0.62mm.The mean thickness of fetal cadaveric lateral menisci at anterior third was 0.91±0.38mm, middle third was 0.23±0.33mm and posterior third was 0.44±0.34mm and mean width of fetal cadaveric menisci at anterior third was 2.94±0.61mm, middle third was 2.88±0.61mm and posterior third was 3.28±0.62mm. CONCLUSION: The present study was done using adult cadaveric specimens, foetal samples and also MRI Images. The primary aim of the study was to understand the developmental changes in the menisci and to compare the morphometric measurements of cadaveric specimens with that of the MRI Images. Establishing the apt morphological type of menisci during clinical imaging is vital as the rarer variants can be mistaken for a pathology. Morphometrics of cadaveric menisci is essential for proper sizing of meniscal scaffolds. In our study we witnessed that various dimensions of medial and lateral menisci measured using formaldehyde preserved cadaveric specimens are significantly smaller when compared to those measured using MRI that denotes actual living values. This difference could be attributed to the shrinkage caused by formaldehyde during preservation. Thus during construction of the menisci scaffolds, the MRI values attests to be a more reliable source rather than the cadaveric meniscal dimensions.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201733251 |
| Uncontrolled Keywords: | Adult cadaveric menisci, fetal cadaveric menisci, MRI Adult menisci. |
| Subjects: | MEDICAL > Anatomy |
| Depositing User: | Subramani R |
| Date Deposited: | 06 Feb 2021 04:22 |
| Last Modified: | 06 Feb 2021 04:22 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13920 |
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