Abstract
Purpose
To study discoid meniscus in children who underwent arthroscopic surgery at our center.
Subjects and methods
Thirty-four patients (39 knees) younger than 15 years with discoid lateral meniscus (mean age, 12.9 years; 13 males, 21 females) who underwent arthroscopic surgeries since 2007 were studied. The surgical procedure consisted of, in principle, saucerization with additional suture repair in the case of meniscal instability at the peripheral rim of the residual meniscus. The mechanisms of symptom onset, symptoms, complications and postoperative outcome in these cases were examined. In addition, Lysholm scores were obtained before surgery and at the last postoperative follow-up in all patients.
Results
Symptom onset was associated with sports in 18 knees, fall in 3 knees, and no definitive trigger in the remaining knees. The presenting symptoms were pain in 32 knees, catching in 11 knees, and locking in 6 knees. According to Watanabe classification, 26 knees were complete type and 13 knees were incomplete type. The modes of tear included horizontal tear in 10 knees and longitudinal tear in 10 knees, while no definitive tear was present on the knee joint surface. The surgical procedures included saucerization only in 22 knees, partial meniscectomy in 10 knees, and saucerization with suture repair in 5 knees. The mean Lysholm score was 63.9 before surgery, and improved significantly to 92.3 at the last follow-up. Only two knees developed osteochondritis dissecans after surgery. Two knees required reoperation; one knee underwent subtotal meniscectomy and one knee had partial meniscectomy with suturing.
Conclusion
Although the short-term outcome after saucerization with or without suture repair for discoid meniscus is favorable, degenerative change or change of lower limb alignment may occur in the long term. Further long-term study is required.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adachi N, Ochi M, Uchio Y, Kuriwaka M, Shinomiya R (2004) Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear. Arthroscopy 20(5):536–542
Ahn JH, Choi S-H, Lee YS et al (2011) Symptomatic torn discoid lateral meniscus in adults. Knee Surg Sports Traumatol Arthrosc 19(2):158–164
Ahn JH, Kim KI, Wang JH, Jeon JW, Cho YC, Lee SH (2015) Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthrosc J Arthrosc Relat Surg 31(5):867–873
Ahn JH, Lee SH, Yoo JC, Lee YS, Ha HC (2008) Arthroscopic partial meniscectomy with repair of the peripheral tear for symptomatic discoid lateral meniscus in children: results of minimum 2 years of follow-up. Arthroscopy 24(8):888–898
Fields LK, Caldwell PE 3rd (2015) Arthroscopic saucerization and repair of discoid lateral meniscal tear. Arthrosc Tech 4(2):e185–e188
Hagino T, Ochiai S, Watanabe Y et al (2013) Usefulness of knee arthroscopy for diagnosis of knee pain in pediatric patients: comparison with preoperative clinical diagnosis. Arch Orthop Trauma Surg 133(5):669–673
Hagino T, Ochiai S, Watanabe Y et al (2014) Complications after arthroscopic knee surgery. Arch Orthop Trauma Surg 134(11):1561–1564
Hashimoto Y, Yoshida G, Tomihara T et al (2008) Bilateral osteochondritis dissecans of the lateral femoral condyle following bilateral total removal of lateral discoid meniscus: a case report. Arch Orthop Trauma Surg 128(11):1265–1268
Manzione M, Pizzutillo PD, Peoples AB, Schweizer PA (1983) Meniscectomy in children: a long-term follow-up study. Am J Sports Med 11(3):111–115
Mizuta H, Nakamura E, Otsuka Y, Kudo S, Takagi K (2001) Osteochondritis dissecans of the lateral femoral condyle following total resection of the discoid lateral meniscus. Arthroscopy 17(6):608–612
Papadopoulos A, Karathanasis A, Kirkos JM, Kapetanos GA (2009) Epidemiologic, clinical and arthroscopic study of the discoid meniscus variant in Greek population. Knee Surg Sports Traumatol Arthrosc 17(6):600–606
Räber D, Friederich N, Hefti F (1998) Discoid lateral meniscus in children. long-term follow-up after total meniscectomy*. J Bone Jt Surg 80(11):1579–1586
Stanitski CL, Bee J (2004) Juvenile osteochondritis dissecans of the lateral femoral condyle after lateral discoid meniscal surgery. Am J Sports Med 32(3):797–801
Wasser L, Knorr J, Accadbled F, Abid A, Sales De Gauzy J (2011) Arthroscopic treatment of discoid meniscus in children: clinical and MRI results. Orthop Traumatol Surg Res OTSR 97(3):297–303
Yoo WJ, Jang WY, Park MS et al (2015) Arthroscopic treatment for symptomatic discoid meniscus in children: midterm outcomes and prognostic factors. Arthroscopy 31(12):2327–2334
Young R (1889) The external semilunar cartilage as a complete disc. Mem Memo Anat 1:179
Zaman M, Leonard MA (1981) Meniscectomy in children: results in 59 knees. Injury 12(5):425–428
Acknowledgments
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Rights and permissions
About this article
Cite this article
Hagino, T., Ochiai, S., Senga, S. et al. Arthroscopic treatment of symptomatic discoid meniscus in children. Arch Orthop Trauma Surg 137, 89–94 (2017). https://doi.org/10.1007/s00402-016-2575-9
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-016-2575-9