Dr. Nicholson and Dr. Petit, are orthopaedic surgery residents, Yale School of Medicine, New Haven, Connecticut. Dr. Egger is an orthopaedic surgery resident, Cleveland Clinic, Cleveland, Ohio. Dr. Saluan is an orthopaedic surgeon, Cleveland Clinic, Cleveland, Ohio. Dr. Carter is an orthopaedic surgeon, NYU School of Medicine, New York, New York.
Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
Address correspondence to: Cordelia W. Carter MD, NYU-Langone Medical Center, Department of Orthopaedic Surgery, 301 East 17th Street, NY, NY 10003 (tel, 212 598-6000; email, cordelia.carter@nyulangone.org).
Am J Orthop. 2018;47(12). Copyright Frontline Medical Communications Inc. 2018. All rights reserved.
Allen Nicholson MD Logan Petit Anthony Egger Paul Saluan and Cordelia W. Carter . Current Concepts: Evaluation and Treatment of Discoid Meniscus in the Pediatric Athlete. Am J Orthop. December 17, 2018
TAKE-HOME POINTS
The discoid meniscus is a congenital variant that is present from birth and may or not become symptomatic as a child matures.
MRI may be used to make the diagnosis of discoid lateral meniscus, defined as 3 or more consecutive sagittal 5-mm cuts demonstrating contiguity of the anterior and posterior horns.
A useful classification system for discoid meniscus describes the shape of the meniscus (complete or partial disc), whether it is torn (torn or intact), and whether it has peripheral instability (stable or unstable).
Surgical treatment of symptomatic discoid lateral meniscus is aimed at restoring normal morphology and stability to the abnormal meniscus.
Short- and mid-term outcomes following partial meniscectomy with repair and/or stabilization as needed are generally good; long-term outcomes following subtotal or complete meniscectomy are poor, demonstrating progression to early arthritis.
References
ABSTRACT
Discoid meniscus is a rare anatomical variant with altered morphology and structure that can sometimes present symptomatically, typically in the pediatric population. The discoid meniscus is usually in the lateral compartment of the knee and is characterized by a partial or complete filling-in of central meniscal tissue, increased meniscal thickness, disorganization of longitudinal collagen fibers, and sometimes lack of peripheral attachments. These changes to both the macro- and micro-structure of the meniscus predispose affected patients to increased rates of both meniscal tears and mechanical symptoms. Surgical management of symptomatic discoid meniscus is directed toward symptom resolution while preserving sufficient functional meniscal tissue to delay or prevent the development of osteoarthritis. Modern surgical techniques consist of arthroscopic saucerization of the discoid meniscus with repair of associated meniscal tears and stabilization of peripheral attachments. Although long-term outcome data are lacking, short- and mid-term outcomes for patients treated with arthroscopic partial meniscectomy and meniscal repair and/or stabilization as needed are generally good.
