LATERAL DISCOID MENISCUS IN CHILDREN

Abstract

Purpose: The purpose of this study was to review the clinical results of a series of 108 children treated artroscopically for symptomatic discoid lateral menisci.

Methods: The medical records of more than 100 consecutive patients who underwent arthroscopic treatment for symptomatic discoid meniscus between 1990 and 2005 were reviewed.

Results: The mean patient age was 8.7 years (range, 2,5 to 14 years), with 55% female and 45% male patients. The mean duration of symptoms before surgery was 20 months (range, 2 to 48 months), with 95% having pain and 38% having mechanical impingment. All patients were treated arthroscopically. Partial or subtotal arthroscopic meniscectomy was performed. Operative classification of the menisci revealed 64 complete, 18 Wrisberg type and 26 incomplete discoid menisci, with meniscal tears being present in 48 knees (45%). At final follow-up, all patients exhibited full knee flexion beyond 135 degrees. Three patients reported residual knee pain, and four reported intermittent mechanical symptoms. At final follow-up, 3 years minimum, according to Ikeuchi clinical score more than 50 % of the patients were considered very good and 25 % good. Only 8 patients felt that their activity level remained partially limited.

Conclusions: Our results show the middle-term efficacy of arthroscopic partial or subtotal meniscectomy in cases of symptomatic lateral discoid menisci. Arthroscopic partial meniscectomy is preferrable only when the posterior attachment of the discoid meniscus is stable. A total meniscectomy is indicated for the Wrisberg-ligament type of discoid meniscus and when the meniscus is completely degenerated. This to our knowledge is the largest series of discoid lateral menisci arthroscopically treated.

Level of evidence: Level IV, therapeutic case series.