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Discoid Lateral Meniscus Evaluation and Treatment.

Jennifer J Beck1, Nirav K Pandya1, Sachin Allahabadi2

  • 1Center for Spine & Orthopedics; Thornton, Colorado, U.S.A.; Department of Orthopaedic Surgery, University of California San Francisco and University of California San Francisco Benioff Children's Hospital Oakland, Oakland, California, U.S.A.; Houston Methodist Orthopedics & Sports Medicine; Houston, Texas, U.S.A.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|May 30, 2025
PubMed
Summary

Discoid lateral meniscus (DLM) is a common knee condition in young patients. Arthroscopic evaluation using the PRiSM classification aids in assessing DLM width, height, stability, and tears for effective surgical treatment.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Knee Anatomy

Background:

  • Discoid lateral meniscus (DLM) is a congenital variant of knee anatomy.
  • DLM frequently affects young, active individuals, causing mechanical symptoms and pain.
  • These meniscal variants are predisposed to tearing, with distinct patterns in children and adults.

Purpose of the Study:

  • To present the PRiSM classification for arthroscopic assessment of discoid lateral meniscus.
  • To outline surgical techniques and tips for managing symptomatic DLMs.
  • To emphasize the importance of thorough evaluation and tailored repair strategies.

Main Methods:

  • Arthroscopic evaluation utilizing the PRiSM classification system.
  • Assessment of meniscal width (Watanabe classes I-II), height, stability, and tear presence.
  • Surgical techniques including portal creation, saucerization, and tear management.

Main Results:

  • The PRiSM classification provides a structured approach to DLM assessment.
  • Specific surgical tips enhance visualization and treatment of DLMs.
  • Saucerization and assessment for tears are critical steps in management.

Conclusions:

  • The PRiSM classification offers a comprehensive framework for evaluating discoid lateral meniscus.
  • Optimal surgical technique and portal management are crucial for successful DLM treatment.
  • Repair of tears, when feasible, combined with augmentation strategies, may improve healing outcomes.