Managing discoid lateral meniscus in children and adolescents: a review of recent advances

Discoid lateral meniscus (DLM) is a structural anomaly characterized by an increased volume and altered collagen fibers, primarily affecting the lateral meniscus. Although its incidence varies, DLM is often present in the pediatric population and may present with acute or chronic knee symptoms, such as joint line pain, mechanical symptoms, and the inability to achieve terminal extension. Diagnosis is typically confirmed through magnetic resonance imaging and clinical evaluation. Histological studies have revealed disorganization and decreased collagen density in DLM, predisposing it to tears and instability. Various classification systems exist, with recent advancements focusing on meniscal width, height, stability, and tears, to guide treatment decisions. Conservative management is suitable for asymptomatic cases, whereas symptomatic patients may benefit from saucerization to restore meniscal function. Surgical intervention, including saucerization and repair, is indicated in cases of peripheral instability or tears. Additionally, addressing mechanical axis deviations in skeletally immature patients is crucial for optimizing the outcomes. This review provides insights into the pathogenesis, classification, and treatment strategies of DLM in children and adolescents.