Arthroscopy - 2026-07-20 - Journal Article; Review
Outcomes of Saucerization With or Without Repair for Symptomatic Discoid Lateral Meniscus in Pediatric Patients: A Systematic Review.
Hartman H, Lessiohadi N, Saharan S, Saraf SM, Christiansen M, Mulcahey MK
Topics
Key Takeaway
Saucerization with or without repair for pediatric discoid lateral meniscus yields significant Lysholm score improvement across all techniques, with saucerization + repair carrying the highest reoperation rate at 8.9% versus 7.3% for saucerization alone.
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Summary
This systematic review evaluated surgical outcomes of symptomatic discoid lateral meniscus in pediatric patients across three technique cohorts: saucerization only, saucerization + repair, and subtotal/total meniscectomy. All three cohorts demonstrated significant postoperative Lysholm score improvement. Saucerization + repair had the highest reoperation (8.9%) and complication rates (6.8%), while saucerization alone had the lowest complication rate (2.7%); OA and OCD were the most frequently reported complications.
Key Limitation
The pooled cohorts are not matched for tear complexity, Watanabe classification, or peripheral instability status, making the apparent difference in reoperation and complication rates between technique groups uninterpretable as a true procedural risk difference.
Original Abstract
PURPOSE
To determine outcomes following operative treatment of symptomatic discoid lateral meniscus (DLM) in pediatric patients.
METHODS
In March of 2024, a systematic review of the MEDLINE, EMBASE, and Cochrane Library databases was conducted. Studies were included if they were published between the years 2013 to 2023, evaluated surgical outcomes of DLM in pediatric patients, and had a minimum of 10 patients per study with a 1-year follow-up. The primary outcome measure was clinical outcomes with a secondary outcome of adverse events. Surgical technique cohorts included the following: saucerization only, saucerization + repair, and subtotal meniscectomy.
RESULTS
Twenty-four studies met inclusion criteria and were included in the analysis. There was a total of 1225 patients (1401 knees; of the studies that reported sex, there were 524/1075 male patients (48.5%) and 553/1075 (51.5%) female patients) who underwent surgical treatment for DLM. The postoperative follow-up time was 1.2 to 10.1 years, and age range was 8.3 to 13.7 years. Saucerization only, saucerization + repair, and total and subtotal meniscectomy cohorts showed significant improvements in Lysholm scores. Saucerization + repair had the highest reoperation (8.9%) and complication rate (6.8%), while saucerization only had the lowest complication (2.7%) and reoperation rate (7.3%). Osteoarthritis and osteochondritis dissecans were the most common complications reported.
CONCLUSIONS
All surgical techniques for symptomatic discoid lateral meniscus in pediatric patients resulted in significant functional improvement and low complication and reoperation rates. Apparent differences between cohorts likely reflect variation in tear complexity and follow-up duration rather than procedural risk. Saucerization with or without repair remains safe and effective when guided by intraoperative assessment of meniscal stability and tear characteristics.
LEVEL OF EVIDENCE
Level IV, systematic review of Level III and IV studies.