Arthroscopic treatment of discoid meniscus in children: clinical and MRI results

Introduction: Treatment of symptomatic discoid meniscus in children is saucerization performed under arthroscopy. The strategy to adopt for associated meniscus lesions is discussed, from partial meniscectomy to meniscal repair. The latter was applied in the series studied herein. The objective was to assess this surgical strategy.

Patients: This was a retrospective study of 20 discoid menisci (18 patients) operated between 2004 and 2007.

Method: The patients first underwent arthroscopic saucerization and then, a procedure that depended on the residual meniscus: no additional procedure if there was no lesion, suturing or reinsertion in cases with a repairable lesion, and partial meniscectomy in cases of a non repairable lesion. All patients were assessed clinically and with postoperative MRI.

Results: The mean follow-up was 37 months. Five discoid menisci presented no lesion and were treated with isolated saucerization. Fifteen discoid menisci presented a lesion. In four cases, saucerization removed this lesion. In eight cases, we performed meniscal repair after saucerization. In three cases, partial meniscectomy was necessary. The Lysholm score ranged from 67 to 88. Sixteen patients were satisfied or very satisfied in 16 cases. The mean Tegner score was 5.9. Postoperative MRI showed no signs of chondral degeneration. The mean measurements of the residual meniscus corresponded to the guidelines. Patients having undergone saucerization associated with meniscal repair had better results than those who had partial meniscectomy or meniscus repair alone (P=0.007, Fisher test).

Discussion: No other study having evaluated discoid meniscus surgery with postoperative MRI has been reported and few studies have been published on saucerization associated with repair. This approach spares the meniscus, as confirmed by MRI, with the size of the residual meniscus within the guidelines. We obtained good clinical and anatomic results, with good healing of the meniscus and satisfactory measurements.