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Case: We report the rare case of a double-layered lateral meniscus that was comprised of a normal meniscus and a ring-shaped accessory meniscus. An 11-year-old boy presented with left knee pain, and magnetic resonance imaging initially was interpreted as showing a horizontal meniscal tear. However, arthroscopic exploration revealed a double-layered meniscus. A superior accessory meniscus was fused with the inferior normal meniscus at the posterior horn and had more mobility compared with the normal meniscus. The symptoms improved substantially after resection of the superior accessory meniscus. The patient returned to sports at 4 months postoperatively; at 15 months postoperatively, radiographs demonstrated no evidence of degenerative changes. Conclusion: A double-layered lateral meniscus that includes a ring-shaped accessory meniscus is a rare abnormality that can be corrected arthroscopically by resection of the accessory meniscus. [ABSTRACT FROM AUTHOR]

Background: Because the use of magnetic resonance imaging is still not universal for the patients with developmental dysplasia of the hip patients, orthopaedists do not generally distinguish widened joint spaces which are "empty" after primary treatment (and therefore still reducible), from those which are filled and much more difficult to treat. To date no studies have focused on the latter hips. We treated and observed the outcomes for 19 hips which showed filled joint spaces after primary treatment., Methods: We retrospectively reviewed 19 cases of developmental dysplasia of the hip: (1) who showed a widened joint space on radiographs after primary treatment; and (2) whose magnetic resonance imaging showed that the widened joint space was accompanied by acetabular cartilage hypertrophy and/or was filled with fibrous tissues. All patients were over 1 year old at the time of primary reduction (reduction was closed in 4 patients, open in 6, and open with pelvic osteotomy in 9). Thirteen patients received at least 1 secondary treatment. Final results were classified using a modified Severin classification., Results: Final outcomes were satisfactory in 10 (52.6%) and unsatisfactory in 9 (47.4%). The widened joint spaces gradually filled with bone, resulting in a shallow acetabulum in the patients with unsatisfactory results. Of 9 patients who underwent combined pelvic osteotomy at the time of primary reduction, results were satisfactory in 6 (66.7%), whereas all patients who had only closed or open primary reduction had unsatisfactory results., Conclusions: Combined pelvic osteotomy at the time of primary reduction is advisable in hips with widened joint spaces. However, hips with filled joint spaces after primary treatment often have unsatisfactory results even after additional pelvic and/or femoral osteotomy., Level of Evidence: Level IV-prognostic study.