Meniscal Injury in the Skeletally Immature Patient

Revision Meniscal Surgery in Children and Adolescents

“…In the pediatric and adolescent populations, multiple factors account for the rising incidence of meniscal injuries, including increasing participation in athletics, expanding use of magnetic resonance imaging (MRI), and earlier diagnosis by physicians. 2,4,11 The importance of functional menisci cannot be minimized, as they play a critical role in shock absorption, load sharing, reduction of contact stresses, and stability within the knee joint. 10,16,18,29 Indeed, early degenerative changes and osteoarthritis become clinically apparent with partial or complete meniscectomies.…”

The Knee: Meniscal Lesions

“…The best candidate for meniscal suture is a young patient with longitudinal lesion size \15 mm, recent, localized at RR area of healthy tissue without previous surgery on the same meniscus, with an associated ACL injury [30]. On the contrary, sutures are not recommended for degenerative menisci, with older injury than 6 months, complex lesion, near WW.…”

Arthroscopic Saucerization and Repair of Discoid Lateral Meniscal Tear

“…5 The enhanced use of magnetic resonance imaging coupled with a heightened awareness has resulted in an increase in diagnosis and subsequent surgical intervention for pediatric meniscal tears. 1 Historical treatment of discoid lateral meniscal tears has shown poor long-term results with total meniscectomy. 6,7 An evolution in the contemporary literature strongly supports repair with meniscal preservation in an effort to restore long-term function.…”

“…4 In contrast, adolescent meniscal tears most commonly are associated with a traumatic event. 1,5 This is the scenario in our case of a wrestler who sustained a tear of the discoid lateral meniscus after maneuvering from a flexed-knee position with an opponent on his back.…”

“…This may be attributable to an increase in sports participation, as well as greater clinical suspicion. 1 The sports medicine physician should be familiar with not only the more common meniscal pathology but also the less frequent symptoms of the discoid meniscus. Although Young 2 originally described the discoid meniscus in 1887, the diagnosis and treatment remain controversial and surgical management continues to evolve.…”