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.

Aims: The aim of this study is to evaluate the effectiveness of a treatment with botulinum toxin type A (BTX-A) in children affected by CP. Methods: Between May 2001 and July 2002, we treated 12 children affected by CP: 11 males, 1 female, mean age 6,42 years; 1 child suffered from tetraplegia, 5 from diplegia and 6 from emiplegia. The injection was carried out in gastrocne-mius muscle (medial and lateral) in 11 patients, in hamstrings in 1 patients in a dose of 6 Units per kg of body weight per muscle. Post-injective treatment included intense physical therapy and orthoses. A clinical and video-recording evaluation, Gross scale and gait-EMG were carried out before injection and 1,3,6 months after. Results: BTX-A treatment has a good functional result: at the þrst control after injection all patients had a complete foot-ground contact instead of toe contact during stance and gait. Conclusion: The results of BTX-A treatment are positive, accordingly to literature: in all patients there was a reduction of spasticity and a complete foot-ground contact, with functional improvement in stance and gait. Good results can be achieved only if the indication is correct: spasticity of the muscle without muscle-tendinous retraction. BTX-A treatment has an effective role in the management of children suffering from CP, where there is no indication for surgical treatment.