Arthroscopic Saucerization and Repair of Discoid Lateral Meniscal Tear

Abstract

Meniscal tears are among the most commonly diagnosed knee injuries and often require surgical intervention. Understanding the types of meniscal tears and treatment options is paramount to caring for the young athlete. Sports medicine and arthroscopic physicians now recognize that meniscal preservation in the young athlete is essential to the longterm health and function of the knee. Although uncommon, the discoid lateral meniscus is more prone to injury because of its increased thickness and lack of blood supply. Because of the abnormal development, the peripheral attachments are frequently absent and instability often persists after a partial meniscectomy. If the instability is unrecognized during the initial treatment, a recurrence of pain and mechanical symptoms is likely and a subsequent subtotal meniscectomy may be the only treatment option. With increased awareness, arthroscopic saucerization accompanied by arthroscopically assisted inside-out meniscal repair is a preferable treatment option with an excellent outcome.

Bilateral Discoid Medial Menisci: A Case Report and Review of the Literature

“… 28 Identifying these patterns in studies supports the concept of meniscus preservation on the notion of redistribution of loading forces within the knee joint to relatively normal anatomic architecture can improve long-term outcomes for patients. 28 , 30 …”

Chinese Experts Consensus and Practice Guideline on Discoid Lateral Meniscus

“…In this case, partial meniscectomy with repair offers the possibility to restore stability and preserve the remnant meniscus with appropriate width and thickness. 4,173,197,200 Therefore, this consensus suggests that repair surgery should be determined based on DLM stability, characteristics of lesions, quality of remnant meniscus, cartilage status, age of the patient, and sports demands.…”

Reconstruction of the Popliteomeniscal Fascicles for Treatment of Recurrent Subluxation of the Lateral Meniscus

“…16 This technique is also indicated for knees with recurrent locking symptoms after other treatments for RSLM, but it is contraindicated for knees with RSLM in which the LM is severely damaged and for RSLM occurring after saucerization of an unstable discoid LM whose peripheral rim is thin and withdrawn from the joint marginal edge (Table 1); this is usually treated by repair at the time of saucerization. 17 We believe that hypermobility of the LM accompanied by idiopathic RSLM is not the cause but rather is the effect of locking symptoms. 1 Therefore, it does not seem justified to perform prophylactic reconstruction of the PMFs to preclude locking symptoms just because the LM is hypermobile; episodes of mechanical locking are definitely required for this technique to be indicated.…”