Young Children with a Bucket-Handle Tear to the Discoid Lateral Meniscus Successfully Treated Using Arthroscopic Saucerization and Repair: Two Case Reports

Liao, Yu-Hsiang; Chen, Chun-Ho; Lin, Chii-Jeng; Su, Wei-Ren; Shih, Chia-Lung; Chiang, Chen‐Hao

doi:10.3390/medicina58101403

Cited by 2 publications

(1 citation statement)

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“…Typically, these patients are asymptomatic [58], however discoid menisci have disorganized collagen, a lack of vascularization, and mucinous degeneration, which increase the risk of tear even in the absence of trauma [53]. Historically, the management of the discoid meniscus was a total meniscectomy, however these procedures were associated with early advanced arthritis [40]. Theoretically, saucerization or partial meniscectomy procedures with or without repair for discoid menisci provide improved function [58].…”

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confidence: 99%

Patients with discoid menisci have similar clinical outcomes to those without discoid menisci when undergoing surgical intervention: a systematic review

Diao

Vivekanantha

Cohen

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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PurposeTo compare post‐operative clinical outcomes of discoid meniscus tear procedures such as saucerization with or without repair with those of non‐discoid meniscus tears such as meniscectomy or repair in skeletally mature patients with no concomitant injuries. MethodsThree databases MEDLINE, PubMed and EMBASE were searched from inception to July 3rd, 2022 for literature describing patient‐reported outcome measures after meniscus surgery in discoid or non‐discoid meniscus tears. The authors adhered to the PRISMA and R‐AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Clinical outcome data on Lysholm, Tegner, International Knee Documentation Committee (IKDC), revision rates, and complications were recorded, with MINORS and Detsky scores used for quality assessment. ResultsA total of 38 studies comprising 2213 patients were included with a mean age of 38.6 years (range: 9.0–64.4). The mean follow‐up time was 54.1 months (range: 1–234) and the average percentage of female participants was 46.8% (range: 9.5–95.5). The mean change between pre‐operative and post‐operative Lysholm scores ranged from 21.0–39.0, 7.4–24.1, and 24.2–48.4 in the discoid, non‐discoid meniscectomy, and non‐discoid repair groups, respectively. The mean change in Tegner scores ranged from 0.0 to 2.3, 1.3, and 0.4–1.3 in the discoid, non‐discoid meniscectomy, and non‐discoid repair groups, respectively. Pre‐operative IKDC scores were not reported, however mean post‐operative IKDC scores ranged from 77.4 to 96.0, 46.9 to 85.7, and 63.1 to 94.0 in discoid, non‐discoid meniscectomy, and non‐discoid repair groups, respectively. Revision rates for discoid procedures, non‐discoid meniscectomies, and non‐discoid meniscus repairs ranged from 3.2 to 44.0%, 8.3 to 56.0%, and 5.9 to 28.0%, respectively. The most common reasons for revision were acute trauma and persistent pain. ConclusionDiscoid saucerization procedures with or without repair leads to similar Lysholm scores as non‐discoid repair procedures, and similar IKDC scores and revision rates compared to non‐discoid meniscectomy or repair procedures. Patients undergoing discoid procedures appeared to have slightly higher Tegner activity scores compared to patients undergoing non‐discoid procedures; however this is to be considered in the context of a younger population of patients undergoing discoid procedures than non‐discoid procedures. This information can help guide surgeons in the decision‐making process when treating patients with discoid menisci, and should guide further investigations on this topic. Level of evidenceIV.

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