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Favorable Long-term Outcomes Following Arthroscopic Preservation Surgery for Pediatric and Adolescent Discoid Lateral
Mohamed Said1, Steven Maxwell Henick1, Zachariah Samuel1
1Department of Pediatric Orthopedic Surgery, Montefiore-Einstein, Bronx, NY.
Background:
Discoid lateral meniscus (DLM) is a congenital anomaly associated with increased risk of tearing and peripheral rim instability due to abnormal morphology and deficient capsular attachments. While total meniscectomy was historically performed, long-term complications have prompted a shift toward arthroscopic saucerization with or without repair. Though midterm outcomes are favorable, long-term data remain limited. This study aimed to evaluate long-term clinical outcomes following arthroscopic preservation surgery for symptomatic DLM and compare results between saucerization alone and saucerization with repair.
Methods:
We performed a retrospective cohort study of patients <21 years who underwent arthroscopic treatment for symptomatic DLM at a single academic pediatric center (2012 to 2022) with a minimum of 5 years of follow-up. Treatment was determined intraoperatively: stable menisci underwent saucerization alone, whereas menisci with PRI and/or meniscocapsular disruption underwent saucerization with repair. PROs included Tegner-Lysholm, Pedi-International Knee Documentation Committee (Pedi-IKDC), and KOOS-Child. Return to full activity and reoperation were assessed via chart review and follow-up documentation.
Results:
Thirty-six patients met the inclusion criteria (mean age, 13.3±3.8 y) with a median follow-up of 8.08 years. PROs at ≥5 years were available for 24 patients (66.7%). Median PROs were favorable in both groups, including Pedi-IKDC (88.5 saucerization-only vs. 94.0 saucerization+repair), Tegner-Lysholm (86.0 vs. 98.0), and KOOS-Child Quality of Life (70.8 vs. 87.8), with no statistically significant differences between groups. Return to full activity was achieved by 35/36 patients (97.2%). Three patients (8.3%) underwent reoperation, with no difference between groups.
Conclusions:
Arthroscopic meniscal preservation for symptomatic DLM in pediatric and adolescent patients is associated with favorable long-term outcomes, high return to full activity, and low reoperation rates. Outcomes were favorable for both stable and unstable DLM treated with saucerization with or without repair.
